Sponsors (16)
The bill reduces out-of-pocket drug costs and simplifies copays for veterans and TRICARE beneficiaries and lowers government drug spending, but risks reducing manufacturer participation, harming access for some patients, and shifting costs onto taxpayers or other markets.
Veterans and TRICARE beneficiaries would pay no more than Medicare Part D cost-sharing for 'selected' negotiated drugs, lowering out-of-pocket costs for patients with chronic conditions who use those medicines.
Aligning TRICARE/VA copays with Medicare Part D simplifies benefits and creates consistent patient cost expectations across federal health programs.
Federal agencies must limit prices in master procurement agreements to the Program's maximum fair price, which is likely to lower government drug purchase costs and reduce spending by taxpayers and public health systems.
Manufacturers may restrict supply to or withdraw products from federal programs to avoid lower master agreement prices, risking reduced access to necessary medicines for veterans and other beneficiaries.
Lower procurement revenues could reduce manufacturers' incentives for new drug R&D or prompt higher prices in non-federal markets, potentially raising costs for taxpayers and middle-class families.
Capping beneficiary copayments at Medicare Part D levels may shift more drug costs onto taxpayers or the federal budget if agencies must absorb higher shares under the negotiated maximum fair price.
Based on analysis of 2 sections of legislative text.
Caps TRICARE beneficiary cost‑sharing and VA copayments for drugs in the federal Drug Price Negotiation Program to the Medicare Part D amount, and limits federal procurement maximum prices to the Program's maximum fair price.
Official title: To amend titles 10 and 38, United States Code, to set the maximum cost-sharing amount paid by an eligible covered beneficiary under the TRICARE program and a veteran for such selected drug, as established under the Social Security Act, and the maximum price of a selected drug procured by Federal agencies, and for other purposes.
Introduced May 7, 2026 by Eugene Simon Vindman · Last progress May 7, 2026
Limits out-of-pocket costs for TRICARE beneficiaries and VA patients for drugs that are chosen under the federal Drug Price Negotiation Program by capping their cost‑sharing to the Medicare Part D amount for the same drug in the same year. Also requires federal master procurement agreements covering those negotiated drugs to reflect the Program's maximum fair price and prohibits manufacturers from putting a higher maximum price into those agreements while the drug remains in the Program. The changes apply only while a drug is a “selected drug” under the Drug Price Negotiation Program, add cross-reference edits, and include transition and reversion rules for existing procurement agreements when the Program is terminated or the drug no longer is selected under the Program.