Share the Savings with Seniors Act

Share the Savings with Seniors Act would change how Medicare Part D determines cost-sharing for chronic care drugs. Starting with plan years beginning on or after January 1, 2027, the bill would require that cost-sharing for chronic care drugs be tied to the drug’s net price (the negotiated price after manufacturer concessions not reflected in the negotiated price), rather than to list prices or other benchmarks. For costs below the annual deductible, cost-sharing cannot exceed the net price. For costs above the deductible and below the plan’s out-of-pocket threshold, coinsurance would generally be based on a percentage of the net price, with an exception if a plan uses a fixed copayment not tied to a percentage of price or to price benchmarks. The bill also defines which drugs count as “chronic care drugs” using USP categories, ensures coverage is guided by these rules, and applies protections for low-income beneficiaries to prevent excessive copayments. Regulators would implement these changes via interim final regulations. In short, the act aims to reduce or cap out-of-pocket costs for chronic care medications by anchoring cost-sharing to the net price and limiting high coinsurance, beginning in 2027, while preserving some plan design flexibility and protecting low-income enrollees.