This bill makes prescription drugs for chronic conditions more affordable for Medicare seniors by limiting how much they have to pay out of pocket. The bill focuses on drugs that treat ongoing health conditions like diabetes and blood clots—medications people typically need to take regularly for months or years.

Right now, seniors can face high costs for these essential drugs. This bill changes that by capping what seniors pay in two ways. First, before they hit their annual deductible, seniors would pay no more than the actual negotiated price the drug company agreed to—basically eliminating extra markups. Second, once they've paid their deductible but haven't reached their yearly spending limit, any percentage-based costs they owe would be calculated based on that same negotiated price, not inflated prices.

In practical terms, if a senior takes a diabetes medication or blood thinner regularly, they'd see lower bills at the pharmacy. Instead of paying whatever their insurance plan charges on top of the drug's actual cost, they'd pay closer to what the drug actually costs after discounts. This is especially important for people managing multiple chronic conditions who need several medications, as it could save them hundreds of dollars per year on prescriptions they can't skip.

Share the Savings with Seniors Act

Cornyn, John

Share the Savings with Seniors ActThis bill limits cost-sharing for chronic care drugs under the Medicare prescription drug benefit. Chronic care drugs include blood glucose regulators other than insulin, anticoagulants, and other categories of drugs as specified in the bill.Specifically, for costs below the annual deductible, the bill caps cost-sharing for chronic care drugs at the net price of the drug (i.e., the negotiated price net of all manufacturer price concessions); for costs above the annual deductible and below the annual out-of-pocket threshold, cost-sharing must be based on a percentage of the drug's net price (if cost-sharing for that drug is tied to the price or cost of the drug).