Capping Prescription Costs Act of 2025

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Bill ID: 119/hr/2553
Last Updated: April 6, 2025

Sponsored by

Rep. Horsford, Steven [D-NV-4]

ID: H001066

Bill's Journey to Becoming a Law

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2. Committee Review: The bill is sent to relevant committees for study, hearings, and revisions.

3. Floor Action: If approved by committee, the bill goes to the full chamber for debate and voting.

4. Other Chamber: If passed, the bill moves to the other chamber (House or Senate) for the same process.

5. Conference: If both chambers pass different versions, a conference committee reconciles the differences.

6. Presidential Action: The President can sign the bill into law, veto it, or take no action.

7. Became Law: If signed (or if Congress overrides a veto), the bill becomes law!

Bill Summary

Another masterpiece of legislative theater, brought to you by the esteemed members of Congress. Let's dissect this farce and expose the underlying disease.

**Main Purpose & Objectives:** The Capping Prescription Costs Act of 2025 is a cleverly crafted bill that claims to limit cost-sharing for prescription drugs. The main purpose? To make politicians look like heroes while doing the bare minimum to address the real issue: skyrocketing healthcare costs. The objective? To appease voters and secure re-election, all while maintaining the status quo.

**Key Provisions & Changes to Existing Law:** The bill proposes to cap cost-sharing for prescription drugs at $2,000 per year for individuals and $4,000 per year for families, starting in 2026. It also makes some minor tweaks to existing laws, including the Patient Protection and Affordable Care Act (ACA) and the Employee Retirement Income Security Act of 1974 (ERISA). These changes are nothing more than a Band-Aid on a bullet wound.

**Affected Parties & Stakeholders:** The usual suspects are involved:

* Politicians: They get to pretend they're doing something about healthcare costs while actually just kicking the can down the road. * Lobbyists: Pharmaceutical companies and health insurance providers will continue to influence policy, ensuring their profits remain intact. * Voters: The poor souls who think this bill will actually make a difference in their lives. Spoiler alert: it won't.

**Potential Impact & Implications:** This bill is a classic case of "too little, too late." It doesn't address the root causes of high healthcare costs, such as price gouging by pharmaceutical companies and the lack of transparency in medical billing. Instead, it provides a temporary fix that will be easily circumvented by the industry.

In reality, this bill will:

* Do nothing to control rising healthcare costs * Fail to hold pharmaceutical companies accountable for their pricing practices * Provide a false sense of security for voters, who will continue to struggle with unaffordable healthcare

Diagnosis: This bill is suffering from a severe case of " Politician-itis," a disease characterized by a lack of courage, vision, and genuine concern for the well-being of citizens. The symptoms include empty promises, half-hearted solutions, and a complete disregard for the root causes of the problem.

Prognosis: Without a drastic change in approach, this bill will be nothing more than a footnote in the history books, a reminder of the ineptitude and cowardice that plagues our political system.

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Project 2025 Policy Matches

This bill shows semantic similarity to the following sections of the Project 2025 policy document. Higher similarity scores indicate stronger thematic connections.

Introduction

Moderate 60.5%
Pages: 497-499

— 465 — Department of Health and Human Services 1. Make Medicare Advantage the default enrollment option. 2. Give beneficiaries direct control of how they spend Medicare dollars. 3. Remove burdensome policies that micromanage MA plans. 4. Replace the complex formula-based payment model with a competitive bidding model. 5. Reconfigure the current risk adjustment model. 6. Remove restrictions on key benefits and services, including those related to prescription drugs, hospice care, and medical savings account plans.26 Legacy Medicare Reform. Legislation reforming legacy (non-MA) Medicare should: l Base payments on the health status of the patient or intensity of the service rather than where the patient happens to receive that service. l Replace the bureaucrat-driven fee-for-service system with value- based payments to empower patients to find the care that best serves their needs. l Codify price transparency regulations. l Restructure 340B drug subsidies27 toward beneficiaries rather than hospitals. l Repeal harmful health policies enacted under the Obama and Biden Administrations such as the Medicare Shared Savings Program28 and Inflation Reduction Act.29 Medicare Part D Reform. The Inflation Reduction Act (IRA) created a drug price negotiation program in Medicare that replaced the existing private-sector negotiations in Part D with government price controls for prescription drugs. These government price controls will limit access to medications and reduce patient access to new medication. This “negotiation” program should be repealed, and reforms in Part D that will have meaningful impact for seniors should be pursued. Other reforms should include eliminating the coverage gap in Part D, reducing the government share in — 466 — Mandate for Leadership: The Conservative Promise the catastrophic tier, and requiring manufacturers to bear a larger share. Until the IRA is repealed, an Administration that is required to implement it must do so in a way that is prudent with its authority, minimizing the harmful effects of the law’s policies and avoiding even worse unintended consequences.30 Medicaid. Over the past 45 years, Medicaid and the health safety net have evolved into a cumbersome, complicated, and unaffordable burden on nearly every state. The program is failing some of the most vulnerable patients; is a prime target for waste, fraud, and abuse; and is consuming more of state and federal budgets. The dramatic increase in Medicaid expenditures is due in large part to the ACA (Obamacare), which mandates that states must expand their Medicaid eligibility standards to include all individuals at or below 138 percent of the federal poverty level (FPL), and the public health emergency, which has prohibited states from performing basic eligibility reviews. The overlap of available benefits among the various health agencies has led to a complex, confusing system that is nearly impossible to navigate—even for recipients. Recipients are often faced with a “welfare cliff” of benefit losses as they earn above a certain amount, which is contrary to the fundamental purpose of empowering individuals to achieve economic independence. Benefits increasingly involve nonmedical services such as air conditioning and housing, many of which are already handled by departments other than HHS. Improper payments within Medicaid are higher than those of any other federal program. These payments are evidence of the inappropriateness of Medicaid’s expansion, which, stemming largely from public health emergency maintenance of effort (MOE) requirements and the Affordable Care Act, has crowded out the primary targets of these programs: those who are most in need. True health care reform cannot be accomplished in a bureaucratic silo or only through Medicaid and health safety net programs. Reform of the tax code is also essential to genuine, effective reform of our health care system. All components of the health care system should be part of the reform efforts, and it is imperative that the system be modified to assist states with their current programs. Therefore, the next Administration should: l Reform financing. Allow states to have a more flexible, accountable, predictable, transparent, and efficient financing mechanism to deliver medical services. This system should include a more balanced or blended match rate, block grants, aggregate caps, or per capita caps. Any financial system should be designed to encourage and incentivize innovation and the efficient delivery of health care services. Federal and state financial participation in the Medicaid program should be rational, predictable, and reasonable. It should also incentivize states to save money and improve the quality of health care.

About These Correlations

Policy matches are calculated using semantic similarity between bill summaries and Project 2025 policy text. A score of 60% or higher indicates meaningful thematic overlap. This does not imply direct causation or intent, but highlights areas where legislation aligns with Project 2025 policy objectives.