,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #faga  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,novemb] #bj1         
#bjbe,mr4 ,au*9closs introduc$ ! foll[+ 
bill2 :i* 0 ref]r$ to ! ,committee on   
,en]gy & ,comm]ce  ,a ,,bill  ,to am5d !
 ,pati5t ,protection & ,af=dable ,c>e   
,act to e/abli% an out-(-pocket limit on
 sp5d+ = prescription drugs4  #a4 ,%ort 
title ,?is ,act may be cit$ z ! ,,aca   
,copay ,co/ & ,af=dability = ,pati5ts   
,act ( #bjbe or ! ,,aca ,copay ,,cap    
,act ( #bjbe4  #b4 ,e/abli%+ an         
out-(-pocket limit on sp5d+ =           
prescription drugs  7a7 ,9 g5]al        
,section #acjb7;c7 ( ! ,pati5t          
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjbb7;c77 is am5d$-- 7#a7 by
 ins]t+ aft] p>agraph 7#a7 ! foll[+ new 
p>agraph3  7#b7 ,annual limitation on   
co/-%>+ = drugs  7,a7 ,9 g5]al ,! annual
 co/-%>+ incurr$ "u a heal? plan )      
respect to prescription drugs disp5s$   
dur+ a plan ye> beg9n+ on or aft]       
,janu>y #a1 #bjbg1 %all n exce$ ! doll> 

am\nt specifi$ 9 subp>agraph 7,b7 )     
respect to su* plan ye>4  7,b7 ,am\nt   
specifi$ ,= purposes ( subp>agraph 7,b71
 ! doll> am\nt specifi$ 9 ?is           
subp>agraph ) respect to a plan ye> is !
 foll[+3 7i7 ,) respect to self-only    
cov]age-- 7,i7 = plan ye>s beg9n+ 9     
#bjbg1 #b1jjj2 &  7,,ii7 = plan ye>s    
beg9n+ 9 #bjbh or a subsequ5t ye>1 !    
doll> am\nt 9 effect "u ?is subp>agraph 
= plan ye>s beg9n+ 9 #bjbg1 increas$ by 
an am\nt equal to ! product ( t am\nt & 
! premium adju/m5t p]c5tage "u p>agraph 
7#d7 = ! cal5d> ye>4  7ii7 ,) respect to
 cov]age o!r ?an self-only cov]age1 =   
plan ye>s beg9n+ 9 #bjbg or a subsequ5t 
cal5d> ye>1 twice ! am\nt 9 effect "u   
clause 7i7 = su* plan ye>4  ,if ! am\nt 
( any increase "u clause 7i7 is n a     
multiple ( #ej1 su* increase %all be    
r\nd$ to ! next l[e/ multiple ( #ej4  2 
&  7#b7 9 p>agraph 7#d7-- 7,a7 by /rik+ 
p>agraph 7#a77;,b77i7 & ins]t+ p>agraphs
 7#a7 & 7#b72 &  7,b7 by /rik+ 7z       
det]m9$ by ! ,secret>y7 & ins]t+ 7or1 = 

purposes ( p>agraph 7#b71 = #bjbg71 z   
det]m9$ by ! ,secret>y4  7b7 ,con=m+    
am5dm5ts  7#a7 ,,ppaca ,section         
#acjb7;e77#a77;,b77i7 ( ! ,pati5t       
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjbb7;e77#a77;,b77i77 is    
am5d$ by ins]t+ & except1 ) respect to  
plan ye>s beg9n+ on or aft] ,janu>y #a1 
#bjbg1 9 ! case ( an individual :o has  
incurr$ co/-%>+ exp5ses ) respect to    
prescription drugs 9 an am\nt equal to !
 limitation 9 effect "u subsection      
7c77#b7 = su* plan ye>1 = b5efits       
consi/+ ( prescription drugs aft]       
section #bgac4  7#b7 ,,phsa ,section    
#bgjg7;b7 ( ! ,public ,heal? ,s]vice    
,act 7#db ,u4,s4,c4 #cjj;gg-#f7;b77 is  
am5d$ by ins]t+ or 7#b7 aft] p>agraph   
7#a74