Medicare Gets First-Ever $5,000 Out-of-Pocket Cap, With $39 Billion Price Tag

Lawmakers introduced the Medicare Cost Cap Act on June 27, capping annual out-of-pocket costs for traditional Medicare enrollees at $5,000—the program's first structural limit in 56 years. The Urban Institute estimates it would increase Medicare spending by $39 billion (7.8 percent). Only 3.2 million high-cost beneficiaries would benefit, saving roughly $1,024 annually on average.