Reducing Drug Prices for Seniors Act

This bill would lower what many Medicare Part D enrollees pay at the pharmacy counter. It says your coinsurance for covered drugs must be based on what the plan actually pays for the medicine after discounts and rebates (the “actual acquisition cost”), not the higher sticker price known as the wholesale acquisition cost, when the actual cost is lower. This change aims to make your share reflect real prices, not list prices.

Starting January 1, 2026, plans must use the actual acquisition cost to calculate coinsurance for drugs on their formulary that use coinsurance instead of a flat copay. The “actual acquisition cost” means the plan’s negotiated price minus any manufacturer price concessions reported for the prior plan year. Some special drug categories are excluded by existing law, but for most covered drugs this rule would apply.

• Who is affected: People with Medicare Part D who pay coinsurance for certain covered drugs.
• What changes: Coinsurance is based on the plan’s real, discounted price rather than the higher list price, which can lower out-of-pocket costs.
• When: Applies to plan years starting on or after January 1, 2026.