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HR 6171119th CongressIn Committee
ACA Copay CAP Act of 2025
Introduced: Nov 20, 2025
Sponsor: Rep. Auchincloss, Jake [D-MA-4] (D-Massachusetts)
Standard Summary
Comprehensive overview in 1-2 paragraphs
The bill amends the Affordable Care Act to establish an annual out-of-pocket limit on prescription drug spending, with a $2,000 cap for individual coverage starting in 2027.
Key Points
- 1Sets $2,000 annual out-of-pocket limit for prescription drugs in 2027
- 2Applies to self-only coverage with automatic increases for subsequent years
- 3Sets $4,000 limit for family coverage (double individual amount)
- 4Increases limits annually based on premium adjustment percentage
- 5Applies to health plans for plan years beginning January 1, 2027 or later
Impact Areas
Healthcare costsPrescription drug affordabilityACA complianceInsurance plansPatients with chronic conditions
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