Congresswoman Manning, Senator Reverend Warnock Introduce New Bill to Cap Out-Of-Pocket Prescription Costs for Patients

Washington, D.C. – Today, Congresswoman Kathy Manning (NC-06) and U.S. Senator Reverend Raphael Warnock (D-GA) introduced new legislation to save families and individuals money on their medications and lower prescription drug costs. The Capping Prescription CostsAct will take proactive steps to protect Americans from rising prescription drug costs by limiting cost-sharing for prescriptions under marketplace health plans and group health plans to $250 per month for an individual and $500 per month for a family. One in four Americans taking a prescription drug has reported skipping doses or cutting pills in half due to costs.

“I have firsthand experience with the exorbitant cost of prescription medication. When my daughter was diagnosed with a chronic illness, the medication her doctor prescribed cost $10,000 per month. My insurance company refused coverage, and I fought until they relented,” said Congresswoman Manning. “I came to Congress to help other families who struggle to pay for their medications. I am proud to introduce this bill to limit the amount families will have to pay for their medications and to help ensure that North Carolinians and people across the country will not have to go without medication they need to stay healthy.”

“In a country as rich and remarkable as the United States, it is shameful that so many hardworking people have to ration their medicines, skip prescription refills, and make other tough tradeoffs about their care because they cannot afford the medication they need to stay healthy,” said Senator Reverend Warnock. “I’m proud to be leading the effort in the Senate to combat the rising out-of-pocket costs for prescriptions drugs that we are seeing all over the country, especially in Georgia, by capping what coverage plans can charge families and individuals.”

According to the Congressional Research Service, many private health insurance plans place an annual cap on enrollee out-of-pocket spending for covered health care services, after which the payer covers the cost. Currently, for 2021, the ACA caps out-of-pocket spending—for all health care expenses, including prescription drug costs—at $8,550 per year for self-only coverage and $17,100 per year for family coverage. Under the Capping Prescription Costs Act, individuals would not pay more than $3,000 and families no more than $6,000 per year for prescription drugs.

According to the Government Accountability Office, the United States spends more than any other country on prescription drugs. Millions of North Carolinians have chronic conditions like cancer, diabetes, and asthma that require specialty medication for treatment and management. Importantly, this legislation will reduce patients’ overall health care spending and mitigate the impact of skyrocketing prescription drug prices on families.  

The Capping Prescription Costs Act is cosponsored by Reps. Carolyn Bourdeax (D-GA), Lois Frankel (D-FL), Lucy McBath (D-GA), Marie Newman (D-IL), and Peter Welch (D-VT). Companion legislation is being led in the U.S. Senate by Senator Reverend Raphael Warnock (D-GA) and is cosponsored by Senators Amy Klobuchar (D-MN), Tammy Baldwin (D-WI), Jack Reed (D-RI) , Patty Murray (D-WA) , Tina Smith (D-MN), Martin Heinrich (D-NM), Richard Blumenthal (D-CT) , Mazie Hirono (D-HI), and Chris Van Hollen (D-MD). This legislation is proudly supported by Community Catalyst, Public Citizen, Families USA, and Protect Our Care.

Read the full bill text here.

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