Bills · HR 6171
IN COMMITTEE· 119TH CONGRESS
House BillHR 6171Health
ACA Copay CAP Act of 2025
INTRO NOV 20· LAST ACTION NOV 20
READING
3MIN
COSPONSORS
0
READER REACTIONS0 TOTAL
NO VOTES YET · BE THE FIRST
- Introduced only
LEGISLATIVE PROGRESS
STEP 2 / 8Introduced
In Committee
Reported
Passed House
Passed Senate
Conference
To President
Became Law
WHAT THE BILL DOES
AI-writtenThe high cost of prescription drugs is a major concern for many Americans, with some families facing thousands of dollars in out-of-pocket expenses even with insurance. This bill matters because it would create a safety net, ensuring that no one with an ACA-compliant plan has to pay an unlimited amount for their medications each year.
If this bill becomes law, it could prevent individuals from having to choose between affording vital medications and other necessities, or from accumulating significant medical debt due to drug costs. If it doesn't pass, people would continue to be subject to their general health plan's overall out-of-pocket maximum, which can be much higher than the proposed drug-specific cap, or face potentially uncapped drug costs depending on their specific plan design.
KEY PROVISIONS
4AI-extractedPROVISION 01
Establishes a new, separate annual out-of-pocket limit specifically for prescription drug spending under health plans regulated by the Affordable Care Act (ACA).
This provision directly addresses the financial burden of high drug costs by creating a dedicated spending cap.
PROVISION 02
Sets the initial annual out-of-pocket limit for self-only coverage at $2,000, starting with plan years beginning on or after January 1, 2027.
It provides a clear, specific maximum amount individuals would pay for drugs each year.
PROVISION 03
Sets the annual out-of-pocket limit for coverage other than self-only (e.g., family coverage) at twice the self-only amount for that year.
This extends the financial protection to families, recognizing their potentially higher collective drug costs.
PROVISION 04
Includes a mechanism to increase the annual out-of-pocket limits in years subsequent to 2027, based on a premium adjustment percentage and rounded to the next lowest $50 increment.
This ensures the cost protection remains relevant and adjusted for inflation over time.
SPONSORSHIP
1 + 0
D· Massachusetts
YRS IN OFFICE
5
BILLS LED
12
ACTION TIMELINE
2 EVENTSNOV 20
Introduced in House
NOV 20
Referred to the House Committee on Energy and Commerce.
BILL INFO
TypeHouse Bill
NumberHR 6171
Congress119th
StatusIn Committee
IntroducedNov 20, 2025
Last actionNov 20, 2025
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IN COMMITTEE· 119TH CONGRESS · ENERGY AND COMMERCE COMMITTEE · INTRODUCED NOV 20, 2025
House BillHR 6171Health
ACA Copay CAP Act of 2025
INTRODUCED NOV 20, 2025· LAST ACTION NOV 20, 2025
PASSAGE CHANCES
—%
READING
3 min
COSPONSORS
0
COMPLEXITY
Moderate
