A Democratic bill with no cosponsors
Last activity — Read twice and referred to the Committee on Finance.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
The Health CARE Act of 2026 aims to expand access to and lower the cost of healthcare across the United States. It creates a new low-cost health plan available through exchanges starting in 2028 and extends enhanced health insurance tax credits. The bill expands Medicare drug price negotiation limits, caps out-of-pocket prescription drug costs at $2,000 for group and individual health plans, and caps monthly insulin cost-sharing at $35. It strengthens price transparency requirements for hospitals, clinical laboratories, imaging providers, and ambulatory surgical centers. Finally, the legislation reforms pharmacy benefit managers, prevents abusive spread pricing in Medicaid, and adds hearing care coverage to Medicare.
Yes· 3 of 27
- Scored +9
Does this lower the price of prescription medicines?
The bill caps out-of-pocket prescription drug costs at $2,000, caps monthly insulin prices at $35, and expands Medicare drug price negotiation.
- Scored +8
Would people over 65 be better off under this?
Seniors gain coverage for hearing aids and audiology services under Medicare, alongside prescription drug price protections.
- Scored +8
Would households on low incomes be better off under this?
Low-income households benefit from enhanced Medicaid support during economic downturns and permanently extended health insurance tax credits.
The opposite
- Scored -2
Would business owners be better off under this?
Business owners face increased regulatory compliance burdens and reporting requirements regarding group health plans.
Who it would affect, and how
Potential Positive Impacts for People
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Out-of-Pocket Prescription Drug Limit: Section 403 establishes an annual out-of-pocket cap of $2,000 on prescription drug expenditures for individuals enrolled in group health plans and group and individual health insurance coverage, which will protect patients from catastrophic medication expenses.
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Affordable Insulin Costs: Section 404 requires group health plans and health insurance issuers to cover selected insulin products without applying a deductible and limits cost-sharing to no more than $35 per 30-day supply, making life-saving diabetes treatment much more affordable.
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Medicare Hearing Care Coverage: Section 504 expands the Medicare program to cover hearing aids and audiology services for individuals diagnosed with moderately severe, severe, or profound hearing loss, helping seniors access necessary hearing health care.
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Medication Step Therapy Exceptions: Section 501 requires group health plans to implement clear and prompt exception processes for medication step therapy protocols, allowing patients to bypass restrictive hurdles when specific medical conditions or previous treatment failures warrant it.
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Expanded Medicare Drug Price Negotiation: Section 401 increases the number of negotiation-eligible drugs for the Medicare drug price negotiation program up to 50 drugs for initial price applicability years, helping lower prescription drug prices for the people.
Potential Negative Impacts for People
- Increased Regulatory and Compliance Burdens: The extensive new reporting, transparency, and data disclosure requirements placed on hospitals, laboratories, imaging providers, and group health plans throughout Titles V and VI could lead to higher administrative overhead costs that might ultimately be passed down to everyday healthcare consumers in the form of higher overall healthcare expenses.
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would households on low incomes be better off under this? — Low-income households benefit from enhanced Medicaid support during economic downturns and permanently extended health insurance tax credits. Would people over 65 be better off under this? — Seniors gain coverage for hearing aids and audiology services under Medicare, alongside prescription drug price protections. Would middle-income households be better off under this? — Middle-class families benefit from caps on prescription drug and insulin costs, along with extended health insurance subsidies. Would people with disabilities be better off under this? — People with disabilities benefit from mandatory step-therapy exception processes and robust out-of-pocket spending caps. Would retired people be better off under this? — Retirees on Medicare benefit from expanded prescription drug price negotiations and newly added hearing care coverage. Would people in middle age be better off under this? — Middle-aged individuals benefit from prescription drug price caps and enhanced health coverage protections. Would people in rural areas be better off under this? — Rural residents benefit from special consideration of rural provider costs and increased FMAP support for state health programs. Would women be better off under this? — Women benefit significantly from comprehensive health coverage provisions, maternity and essential health benefit protections, and out-of-pocket caps. Would people in their twenties and thirties be better off under this? — Young adults benefit from extended ACA tax credits and low-cost health exchange plan options. Would Black Americans be better off under this? — Minority communities disproportionately benefit from expanded Medicaid support and increased access to affordable healthcare. Would Hispanic Americans be better off under this? — Hispanic Americans benefit from provisions expanding health coverage access and consumer navigator assistance for limited English speakers. Would union members be better off under this? — Union members covered by employer-sponsored group health plans benefit from enhanced transparency, data access, and drug cost protections. Would veterans be better off under this, taking everything together? — Veterans benefit from improved healthcare cost protections, expanded drug price negotiations, and transparency measures. Would people in cities be better off under this? — Urban residents benefit from expanded health exchange options and increased price transparency across local facilities. Would children be better off under this? — The bill mandates child-only health plans and expands health coverage affordability for families. Would business owners be better off under this? — Business owners face increased regulatory compliance burdens and reporting requirements regarding group health plans.
- Healthcare
- Does this lower the price of prescription medicines? — The bill caps out-of-pocket prescription drug costs at $2,000, caps monthly insulin prices at $35, and expands Medicare drug price negotiation. Does this make health care easier to get in general? — The bill establishes a new low-cost health plan, expands Medicaid support, and improves overall healthcare coverage and access. Does this strengthen the Affordable Care Act? — The bill permanently extends enhanced ACA health insurance tax credits and funds consumer outreach. Does this put more money into Medicaid, the health coverage for people on low incomes? — The legislation enhances FMAP rates during economic downturns and permanently improves financing for newly eligible Medicaid individuals. Does this lower what people pay for private health insurance? — Extended subsidies and drug price negotiation provisions help reduce out-of-pocket costs and overall private insurance expense. Does this do more about addiction and overdose deaths? — Navigator training provisions specifically incorporate opioid-specific education and treatment options. Does this lower what a hospital stay costs? — The legislation institutes stringent hospital and ambulatory surgical center price transparency requirements to lower overall care costs. Does this put more money into Medicare, the health coverage for people over 65? — The bill expands Medicare benefits to include hearing care coverage and audiology services.
- Economy And Finance
- Does this give people more protection from unfair business practices? — The legislation enacts broad healthcare and prescription drug price transparency requirements and protects patients from surprise billing and excess charges. Is this likely to grow the economy? — The bill lowers healthcare costs and prescription drug prices, which reduces the overall economic burden of medical care on households and businesses.
- Governance And Ideology
- Does this make what the government does easier for the public to see? — The bill imposes extensive price transparency, billing disclosures, and ownership reporting requirements on hospitals, laboratories, and insurers.
- Social Issues And Justice
- Is this likely to lift people out of poverty? — Lowering out-of-pocket medical and prescription drug expenses helps alleviate financial distress for low-income households.
- 9/24/2026
- Read twice and referred to the Committee on Finance.
- Introduced in Senate