Lower prescription drug costs by extending annual cap on out-of-pocket expenses on drugs to all insurance plans
Extend the annual cap on out-of-pocket prescription drug expenses to all insurance plans.
Occurrences
The bill text states that a group health plan and health insurance issuer offering group health insurance coverage shall ensure that cost-sharing for covered prescription drugs does not exceed ACA section 1302(c)(5) limitations, showing a concrete proposal to extend prescription-drug out-of-pocket caps beyond Medicare.
Bill text includes a 'Limitation on prescription drug out-of-pocket cost' provision for group health plans and health insurance issuers.
Evidence
Congressional Record materials from January 22, 2026 include legislative text concerning prescription drug cost-sharing limits for group health plans and health insurance issuers, reflecting ongoing congressional activity on extending out-of-pocket caps beyond Medicare Part D.
The bill text states that a group health plan and health insurance issuer offering group health insurance coverage shall ensure that cost-sharing for covered prescription drugs does not exceed ACA section 1302(c)(5) limitations, showing a concrete proposal to extend prescription-drug out-of-pocket caps beyond Medicare.
Bill text includes a ‘Limitation on prescription drug out-of-pocket cost-’ provision for group health plans and insurance issuers, indicating continued effort to cap prescription-drug spending across private coverage.
Moulton’s official site shows a May 26, 2026 policy reintroduction press release for an unrelated bill, with no mention of enactment of a prescription-drug out-of-pocket cap for all insurance plans.
The official office news page shows recent releases from May 2026, but none in the retrieved record report passage or implementation of a universal prescription-drug out-of-pocket cap across all insurance plans.
Assessments
The available evidence shows serious congressional effort to extend prescription-drug out-of-pocket caps beyond Medicare, including introduced bill text covering group health plans and insurance issuers. However, the record provided does not show that a universal cap across all insurance plans was enacted or implemented. Under the scoring rule, a serious legislative attempt that failed to deliver the promised outcome should be scored as never with effort_badge=true.