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CIVIC HERALD
HR 6166 · 119th Congress · HouseIn committee

Lowering Drug Costs for American Families Act

In plain language: This bill expands federal prescription drug price negotiations from 20 to 50 medications and extends those discounted prices to people with private and job-based health insurance. Starting in 2027, most private health plans must cap an individual's out-of-pocket prescription drug spending at $2,000 per year and limit insulin copays to no more than $35 per month without requiring a deductible. In addition, the legislation requires drug manufacturers to pay rebates if they increase commercial drug prices faster than inflation and requires federal negotiators to factor in prices paid in six peer countries starting in 2028.

Provisional: our plain-language summary, pending review.

Provisionalunreviewed: impact, issue tags, provisions, stakeholders, summary
People affectedThe bill applies broadly to participants, beneficiaries, and enrollees in Medicare, group health plans, and individual health insurance markets nationwide, but does not provide a specific population count.
Fiscal magnitudeno CBO estimate published
Reach85provisional · pending reviewrigor: heuristic llm
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Issues

What this bill touches.

Government role in coverage+40Pharmaceutical pricing+70

The sign shows the bill's direction on each issue (+ toward, − away); the number is its magnitude. Color never encodes good or bad, and never party.

Who it affects

Who it helps · who it burdens.

Who it helps

  • Enrollees in private commercial and group health plansReceive lower out-of-pocket prescription drug costs through a $2,000 annual spending cap (starting in 2027), a $35 monthly cap on selected insulin products with no deductible, and access to Medicare-negotiated drug prices in participating plans.provisional
  • Medicare beneficiariesGain access to up to 50 negotiated drug prices annually instead of 20, with federal negotiations incorporating international reference pricing from six countries starting in 2028.provisional
  • Individuals under age 21Gain access to dedicated child-only health plan options from issuers that offer tiered health coverage in individual and group markets.provisional

Who it burdens

  • Prescription drug manufacturersMust pay mandatory inflation rebates to the federal government on prescription drugs sold in the commercial market when price increases outpace inflation, and face expanded price negotiation on up to 50 drugs per year benchmarked against international prices.provisional
  • Group health plans and health insurance issuersMust limit annual prescription drug out-of-pocket cost-sharing to $2,000, cap insulin copays at $35 per month with zero deductible, offer child-only plans, and either provide Medicare-negotiated drug prices to enrollees or formally opt out and publish disclosure notices.provisional

Who backs it

  • Prescription drug manufacturersPay mandatory inflation rebates on commercial sales of Part B and Part D drugs if prices increase faster than inflation.provisional

Dollar-level funding (FEC sector totals) is coming in a later phase.

What it does

The provisions, in plain language.

  1. Increases the maximum number of high-spend prescription drugs selected each year for Medicare price negotiation from 20 to 50.

    Sec. 101(a)provisional
  2. Extends Medicare-negotiated maximum drug prices to private commercial health plans and individual health insurance, requiring participating plans to cap enrollee cost-sharing for negotiated drugs at the negotiated price unless the plan affirmatively opts out.

    Sec. 101(b)–(e)provisional
  3. Requires federal negotiators, starting in 2028, to consider average drug prices in Australia, Canada, France, Germany, Japan, and the United Kingdom when negotiating Medicare drug prices.

    Sec. 102provisional
  4. Applies Medicare Part B prescription drug inflation rebates to units dispensed in the commercial insurance market, requiring manufacturers to pay rebates when commercial prices rise faster than inflation.

    Sec. 201(a)provisional
  5. Applies Medicare Part D prescription drug inflation rebates to units dispensed in the commercial market, requiring manufacturers to pay rebates on commercial sales if price increases exceed inflation.

    Sec. 201(b)provisional
  6. Caps annual out-of-pocket prescription drug spending under group health plans and individual health insurance at $2,000 for self-only coverage (and $4,000 for other coverage) starting in 2027, with annual inflation adjustments in subsequent years.

    Sec. 301provisional
  7. Caps cost-sharing for selected insulin products under private group and individual health plans at no more than $35 or 25% of the negotiated price per 30-day supply, and prohibits plans from applying deductibles to those products starting in 2027.

    Sec. 302provisional

How your members of Congress line up

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Timeline

How it moved.

  1. Nov 20, 2025Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
  2. Nov 20, 2025Introduced in House
  3. Nov 20, 2025Introduced in House

The original text

Read it for yourself.

Sources & provenance

Congress.govrefreshed 9 days ago

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