RxCAP Act of 2019

II 116TH CONGRESS 1ST SESSION S. 475 To amend title XVIII of the Social Security Act to prevent catastrophic out-of-pocket spending on prescription drugs for seniors and individuals with disabilities. IN THE SENATE OF THE UNITED STATES FEBRUARY 13, 2019 Mr. WYDEN (for himself, Mr. BENNET, Mr. CARDIN, Ms. KLOBUCHAR, Mr. MERKLEY, and Mr. WHITEHOUSE) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to prevent catastrophic out-of-pocket spending on prescription drugs for seniors and individuals with disabilities. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Reducing Existing 4 Costs Associated with Pharmaceuticals for Seniors Act of 5 2019’’ or the ‘‘RxCAP Act of 2019’’. 6 VerDate Sep 11 2014 04:19 Feb 22, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S475.IS S475 kjohnson on DSK79L0C42 with BILLS 2 •S 475 IS SEC. 2. ELIMINATION OF COST-SHARING ABOVE THE MEDI- 1 CARE PART D ANNUAL OUT-OF-POCKET 2 THRESHOLD. 3 (a) IN GENERAL.—Section 1860D–2(b)(4)(A) of the 4 Social Security Act (42 U.S.C. 1395w–102(b)(4)(A)) is 5 amended— 6 (1) in clause (i)— 7 (A) by redesignating subclauses (I) and 8 (II) as items (aa) and (bb), respectively, and in- 9 denting appropriately; 10 (B) by striking ‘‘subparagraph (B), with 11 cost-sharing’’ and inserting the following: ‘‘sub- 12 paragraph (B)— 13 ‘‘(I) for plan years 2006 through 14 2019, with cost-sharing’’; 15 (C) in item (bb), as redesignated by sub- 16 paragraph (A), by striking the period at the 17 end and inserting ‘‘; and’’; and 18 (D) by adding at the end the following new 19 subclause: 20 ‘‘(II) for plan year 2020 and sub- 21 sequent plan years, without any cost- 22 sharing.’’; and 23 (2) in clause (ii)— 24 (A) by striking ‘‘clause (i)(I)’’ and insert- 25 ing ‘‘clause (i)(I)(aa)’’; and 26 VerDate Sep 11 2014 04:19 Feb 22, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S475.IS S475 kjohnson on DSK79L0C42 with BILLS 3 •S 475 IS (B) by adding at the end the following new 1 sentence: ‘‘The Secretary shall continue to cal- 2 culate the dollar amounts specified in clause 3 (i)(I)(aa), including with the adjustment under 4 this clause, after plan year 2019 for purposes 5 of 1860D–14(a)(1)(D)(iii).’’. 6 (b) CONFORMING AMENDMENTS TO LOW-INCOME 7 SUBSIDY.—Section 1860D–14(a) of the Social Security 8 Act (42 U.S.C. 1395w–114(a)) is amended— 9 (1) in paragraph (1)— 10 (A) in subparagraph (D)(iii), by striking 11 ‘‘1860D–2(b)(4)(A)(i)(I)’’ and inserting 12 ‘‘1860D–2(b)(4)(A)(i)(I)(aa)’’; and 13 (B) in subparagraph (E)— 14 (i) in the heading, by inserting 15 ‘‘PRIOR TO THE ELIMINATION OF SUCH 16 COST-SHARING FOR ALL INDIVIDUALS’’ 17 after ‘‘THRESHOLD’’; and 18 (ii) by striking ‘‘The elimination’’ and 19 inserting ‘‘For plan years 2006 through 20 2019, the elimination’’; and 21 (2) in paragraph (2)(E)— 22 (A) in the heading, by inserting ‘‘PRIOR TO 23 THE ELIMINATION OF SUCH COST-SHARING FOR 24 ALL INDIVIDUALS’’ after ‘‘THRESHOLD’’; 25 VerDate Sep 11 2014 04:19 Feb 22, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S475.IS S475 kjohnson on DSK79L0C42 with BILLS 4 •S 475 IS (B) by striking ‘‘Subject to’’ and inserting 1 ‘‘For plan years 2006 through 2019, subject 2 to’’; and 3 (C) by striking ‘‘1860D–2(b)(4)(A)(i)(I)’’ 4 and inserting ‘‘1860D–2(b)(4)(A)(i)(I)(aa)’’. 5 Æ VerDate Sep 11 2014 04:19 Feb 22, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\S475.IS S475 kjohnson on DSK79L0C42 with BILLS