Baldwin Introduces Bill to Cap Prescription Drug Costs for Over 3.3 Million Wisconsinites

WASHINGTON, D.C. - U.S. Senator Tammy Baldwin (D-WI) introduced new legislation to lower the cost of prescription drugs for millions of Americans. The Capping Prescription Costs Act would place annual caps on out-of-pocket costs for prescription drugs-$2,000 for individuals and $4,000 for families, building on the success of the Inflation Reduction Act, which capped prescription drug cost-sharing for Medicare Part D beneficiaries, extending the savings to the commercial health care market.

"No American should have to choose between basic necessities like putting food on the table and paying for the drugs they need to stay healthy. While we've made great progress cutting costs for Wisconsin Seniors with the Inflation Reduction Act, every American should be protected from big drug companies price practices," said Senator Baldwin. "Our legislation will lower expenses for Wisconsinites across the state and ensure that more families can get the medication they need at a price they can afford."

Over 60 percent of American adults take at least one prescription drug, with 25 percent of adults taking four or more. In 2019, Wisconsin residents spent an estimated $1.3 billion on prescription drugs. Americans often pay more for the same prescription drugs than people in other countries, and due to the cost burden, American patients often cannot afford their medications as prescribed. This results in patients skipping doses, cutting doses in half, or taking over-the-counter medications instead of their prescriptions. One study found that 31 percent of patients did not take their medications as prescribed due to cost.

The Capping Prescription Costs Act would extend the out-of-pocket cost cap seniors on Medicare will see in 2025 from the Inflation Reduction Act to the commercial health care market. The new $2,000 cap on cost-sharing for individuals and $4,000 for families will apply to all of the 173 million Americans who have private health insurance. Nationwide, 173 million people under age 65 have private health insurance, either from an employer plan (155 million) or the non-group market (18 million). In Wisconsin, over 3.3 million people under 65 have private health insurance. The Capping Prescription Drug Costs Act will ensure that prescription drugs are more affordable for these millions of Americans.

Senator Baldwin has been committed to bringing down prescription drug costs. In August 2022, Senator Baldwin helped pass the Inflation Reduction Act (IRA) to lower health care and prescription drug costs for older adults, people with disabilities, and families across the nation. Starting in January 2023, the IRA capped the cost of insulin for Medicare Part D beneficiaries at $35 a month for certain covered insulin products. The law also will limit Medicare beneficiaries' out-of-pocket costs to $2,000 per year beginning in 2025.

Senator Baldwin also launched an investigation into the extremely high prices four large pharmaceutical companies charge for inhalers that 25 million Americans with asthma and 16 million Americans with chronic obstructive pulmonary disease (COPD) rely on to breathe. In just two months after the investigation was launched, three of the four pharmaceutical companies capped their out-of-pocket costs for their inhaler products at $35 per month in the United States.

This legislation is led by U.S. Senators Bob Casey (D-PA) and Reverend Raphael Warnock (R-GA). A one-pager on the Capping Prescription Costs Act is available here.

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