H.R. 5197 explained · 119th Congress · Pending in Congress
Protect Beneficiaries from Middlemen Act
Cosponsors: none · per Congress.gov, 2026-10-11
Introduced: 2025-09-08
Latest action (2025-09-08): Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
What H.R. 5197 does, in plain terms
Protect Beneficiaries from Middlemen Act This bill limits cost-sharing for covered drugs under the Medicare prescription drug benefit and Medicare Advantage. Specifically, for costs above the deductible but below the annual out-of-pocket threshold, the bill limits cost-sharing to the average net price of the drug (i.e., the average amount paid less any rebates) or the cash price (i.e., the price charged to an individual without insurance), whichever is lower. The Government Accountability Office must report on the bill's implementation.
Official summary by the Congressional Research Service, via Congress.gov.
Constitution Index
“VFA Constitution grade”
Not graded yet
H.R. 5197 has not been graded yet. New measures with an official summary are graded daily under the published rubric.
What should pass
“VFA SI Solution”
No solution yet
A sourced SI draft appears here once it passes automated checks (Constitution citation, source verification, independent SI critic). How publication works.
For journalists and bloggers
“Embed this grade”
Free to use with the link back. The badge and card update when the grade changes. Embed terms →
