H.R.4649: Capping Drug Costs for Seniors Act of 2019

The Capping Drug Costs for Seniors Act (H.R. 4649) would create an out-of-pocket prescription drug cap of $2,000 for patients who use Medicare Part D. The bill would also require health plans to pay more in the catastrophic coverage phase, the phase after a patient has paid $5,100 (in 2019, $6,350 in 2020) in out-of-pocket costs for covered drugs. During this phase, individuals have reduced copay’s or coinsurance for the remainder of the year. It would also reduce reinsurance subsidies, or payments to individual-market plans when their annual cost for an enrollee exceeds a specified amount, and expand the current Medicare coverage gap discount program into a benefit-wide responsibility.