Cutting Copays Act
Summary
The "Cutting Copays Act" (H.R. 4139) proposes amendments to Title XVIII of the Social Security Act, specifically targeting Medicare Part D cost-sharing reductions for low-income individuals. The bill aims to adjust copayments for generic and other drugs for plan years before and after 2026. It seeks to eliminate copays for generic drugs in 2026 and adjust other drug copays based on previous year amounts and consumer price index increases.
Expected Effects
If enacted, the bill would likely reduce or eliminate copayments for generic drugs for low-income Medicare Part D beneficiaries starting in 2026. Copayments for other drugs would be adjusted annually based on inflation. This could lead to increased access to prescription medications for low-income individuals.
Potential Benefits
- Reduced out-of-pocket expenses for low-income Medicare Part D beneficiaries.
- Increased access to generic medications, potentially improving health outcomes.
- Simplified cost-sharing structure for generic drugs.
- Annual adjustments to copays based on inflation, maintaining affordability.
- Potential for improved medication adherence due to lower costs.
Most Benefited Areas:
Potential Disadvantages
- Potential increased costs to the Medicare program, which could impact premiums or taxes.
- Complexity in implementing and administering the annual copay adjustments.
- Possible shift in costs to other areas of the healthcare system.
- The act does not address the underlying cost of drugs, only the copays.
- Inflation adjustments may not accurately reflect changes in drug costs.
Constitutional Alignment
The bill falls under the purview of Congress's power to provide for the general welfare, as outlined in the Preamble of the US Constitution. Specifically, it relates to healthcare, which is often considered part of the general welfare. Article I, Section 8 grants Congress the power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).