ACA Copay CAP Act of 2025

This bill would change the Affordable Care Act to set a yearly limit on how much a person pays out of pocket for prescription drugs under a health plan. Starting with plan years beginning in 2027, the limit would be $2,000 for self-only coverage and twice that amount for other coverage, such as family plans. After 2027, the limit would be adjusted each year using the law's premium adjustment percentage, rounded down to a multiple of $50. The bill also applies the limit to group health plans through the Public Health Service Act and changes how catastrophic plans cover drugs once a person reaches the limit.

Full text and official record on Congress.gov

Sponsors

• Jake Auchincloss Democrat sponsor
• 0 cosponsors