Fair Prescription Pricing Act of 2026
Latest action (20 Aug 2026): Introduced
What this bill does
**H.R. 10133 — Fair Prescription Pricing Act of 2026**
This bill would cap what patients pay out-of-pocket for prescription drugs at in-network pharmacies. Specifically, it would prohibit group health plans and health insurance issuers (offering group or individual coverage) from charging cost sharing—deductibles, coinsurance, or copayments—for a covered outpatient drug that exceeds the nationwide average consumer purchase price for that drug, as measured over the prior year using data from an existing federal drug pricing survey referenced in the Social Security Act. The limit would apply starting with plan years beginning after the bill's enactment, and plans/issuers would be responsible for ensuring any pharmacy benefit managers they use also comply.
The bill affects people enrolled in employer-sponsored and individual health insurance plans, as well as insurers, group health plans, and pharmacy benefit managers, who would need to adjust cost-sharing structures to comply with the new cap. It amends three separate federal laws—the Public Health Service Act, the Employee Retirement Income Security Act (ERISA), and the Internal Revenue Code—to apply consistently across different types of health coverage.
The bill was introduced on August 20, 2026, by Rep. Hillary Scholten and referred to the House Committees on Energy and Commerce, Ways and Means, and Education and Workforce. It has not yet received committee action, and would need to pass the House, the Senate, and be signed by the President before taking effect.
Plain-English summary generated by Bill100 AI from the official record. Always verify against the source below.
Official summary
This bill is in the first stage of the legislative process. It was introduced into Congress on August 20, 2026. It will typically be considered by committee next before it is possibly sent on to the House or Senate as a whole.
Common questions
- What does H.R. 10133 do?
- **H.R. 10133 — Fair Prescription Pricing Act of 2026** This bill would cap what patients pay out-of-pocket for prescription drugs at in-network pharmacies. Specifically, it would prohibit group health plans and health insurance issuers (offering group or individual coverage) from charging cost sharing—deductibles, coinsurance, or copayments—for a covered outpatient drug that exceeds the nationwide average consumer purchase price for that drug, as measured over the prior year using data from an existing federal drug pricing survey referenced in the Social Security Act. The limit would apply starting with plan years beginning after the bill's enactment, and plans/issuers would be responsible for ensuring any pharmacy benefit managers they use also comply. The bill affects people enrolled in employer-sponsored and individual health insurance plans, as well as insurers, group health plans, and pharmacy benefit managers, who would need to adjust cost-sharing structures to comply with the new cap. It amends three separate federal laws—the Public Health Service Act, the Employee Retirement Income Security Act (ERISA), and the Internal Revenue Code—to apply consistently across different types of health coverage. The bill was introduced on August 20, 2026, by Rep. Hillary Scholten and referred to the House Committees on Energy and Commerce, Ways and Means, and Education and Workforce. It has not yet received committee action, and would need to pass the House, the Senate, and be signed by the President before taking effect.
- Has H.R. 10133 become law?
- Not yet. As of 20 Aug 2026, H.R. 10133 is introduced.
- Who sponsored H.R. 10133?
- H.R. 10133 was sponsored by Rep. Hillary Scholten [D-MI3] (Democrat-MI), with 0 cosponsors.
- What's the latest action on H.R. 10133?
- Introduced (20 Aug 2026).
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