Loading…
S. 4323119th CongressIn committeeLatest action Apr 16, 2026Decoded by AI · checked against the record
Official title: Ensuring Access to Lower-Cost Medicines for Seniors Act
Introduced:
Read the official bill on Congress.govThe plain-language version leads. The official text is always the reference.
Starting in 2028, Medicare drug plans must cover lower-cost generics and biosimilars and place them on cheaper tiers when a brand-name version is already covered.
55-second read · 4 questions answered below
This bill requires Medicare prescription drug plans to automatically add generic drugs and biosimilar medicines to their covered drug lists when a brand-name version is already covered and the generic or biosimilar costs less. Those generics and biosimilars must be placed on a separate, cheaper cost-sharing tier, with copayments at least $20 lower than the cheapest brand-name tier. Plans also cannot use tools like prior authorization or step therapy in ways that make it harder to get a generic or biosimilar than its brand-name version.
Medicare beneficiaries enrolled in Part D prescription drug plans or Medicare Advantage plans with drug coverage would be affected. Insurance companies that run those plans would be required to restructure their drug lists and pricing tiers to follow the new rules.
Seniors enrolled in these plans would pay less out of pocket for generic and biosimilar medicines compared to brand-name drugs. Insurance plans would need to update how they organize covered drug lists and cost-sharing tiers starting in 2028.
AI-drafted summary. Verify it against the official text before you act on it. Read the official bill on Congress.gov
Right now: a Senate committee is reviewing it. If the House changes it, it goes back to the Senate before reaching the President.
Latest action: — Read twice and referred to the Committee on Finance.