Lowering Drug Costs for American Families Act

Lowering Drug Costs for American Families Act

This bill expands the Medicare Drug Price Negotiation Program to include additional drugs and drugs that are covered under private insurance. It also extends certain rebate requirements for covered drugs under Medicare to drugs that are covered under private insurance.

Current law requires the Centers for Medicare & Medicaid Services (CMS) to negotiate maximum prices for brand-name drugs that do not have other generic equivalents and that account for the greatest Medicare spending; the CMS must eventually negotiate the prices of 20 drugs that are covered under Medicare in 2029 and each year thereafter.

The bill requires the CMS to negotiate the prices of 50 drugs beginning in 2029. It also applies the negotiated maximum prices under the program to drugs that are covered under private health insurance, unless the insurer opts out. The CMS, Department of Labor, and Department of Treasury must publish a list of insurers that choose to opt out; insurers must also publicly disclose their decision to opt out.

Current law also requires drug manufacturers to issue rebates to the CMS for brand-name drugs without generic equivalents under Medicare that cost $100 or more per year per individual and for which prices increase faster than inflation. The bill extends these requirements to drugs that are covered under private insurance.