H.R. 4139 — Cutting Copays Act

This section revises maximum copayments for covered Part D drugs for full-benefit dual eligible individuals (i.e., low-income Medicare beneficiaries eligible for full premium and cost-sharing subsidies under Medicare Part D). (1) For plan years before 2026, it establishes copays of $1 (or the lower plan copay amount under subclause (iii)) for generic drugs or preferred multiple-source drugs (as defined in SSA section 1927(k)(7)(A)(i)) and $3 (or lower) for other drugs (previously $1); and (2) for 2026, it sets copays at $0 for generic drugs and, for other drugs, the amount applied in 2023 (after adjustment under paragraph (4)(A)); with (3) annual increases thereafter by the consumer price index for all urban consumers (U.S. city average) as of September of the prior year.