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To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program.

1/6/2025, 11:41 PM

Summary of Bill HR 4881

Bill 118 hr 4881, also known as the "Medicare Drug Cost Sharing Limitation Act," aims to make changes to the Medicare program in order to limit the amount that beneficiaries have to pay for prescription drugs. The bill specifically focuses on amending title XVIII of the Social Security Act, which governs Medicare.

Under the proposed legislation, there would be a cap placed on the amount of cost sharing that Medicare beneficiaries would have to pay for their prescription drugs. This would help to alleviate the financial burden that many seniors and individuals with disabilities face when trying to afford necessary medications.

The bill is designed to ensure that Medicare beneficiaries have access to affordable prescription drugs, while also working to control overall healthcare costs. By limiting cost sharing for drugs, the hope is that individuals will be more likely to adhere to their prescribed medication regimens, leading to better health outcomes and potentially reducing the need for more costly medical interventions down the line. Overall, the "Medicare Drug Cost Sharing Limitation Act" seeks to improve the affordability and accessibility of prescription drugs for Medicare beneficiaries, ultimately aiming to improve the overall health and well-being of those enrolled in the program.

Congressional Summary of HR 4881

This bill limits cost-sharing for covered drugs under the Medicare prescription drug benefit and Medicare Advantage.

Specifically, for costs above the deductible but below the annual out-of-pocket threshold, the bill limits cost-sharing to the average net price of the drug (i.e., the average amount paid less any rebates) or the cash price (i.e., the price charged to an individual without insurance), whichever is lower. 

The Government Accountability Office must report on the bill's implementation.

Current Status of Bill HR 4881

Bill HR 4881 is currently in the status of Bill Introduced since July 25, 2023. Bill HR 4881 was introduced during Congress 118 and was introduced to the House on July 25, 2023.  Bill HR 4881's most recent activity was Referred to the Subcommittee on Health. as of December 17, 2024

Bipartisan Support of Bill HR 4881

Total Number of Sponsors
3
Democrat Sponsors
0
Republican Sponsors
3
Unaffiliated Sponsors
0
Total Number of Cosponsors
2
Democrat Cosponsors
0
Republican Cosponsors
2
Unaffiliated Cosponsors
0

Policy Area and Potential Impact of Bill HR 4881

Primary Policy Focus

Health

Potential Impact Areas

- Congressional oversight
- Government studies and investigations
- Health care costs and insurance
- Medicare
- Prescription drugs

Alternate Title(s) of Bill HR 4881

To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program.
To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program.

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