Ensuring Access to Lower-Cost Medicines for Seniors Act of 2026.

This bill amends the Medicare Part D prescription drug program to require that, starting in 2027, plan sponsors using a formulary must include certain lower-cost generic drugs and biosimilar biological products in a preferred position relative to their reference drugs. It also prohibits the plan from imposing more restrictive access limits on these generics and biosimilars than on the reference drugs.

Sec. 2, Requirements for PDP sponsors of prescription drug plans under Part D of the Medicare program that use formularies: This section adds a new requirement to the Social Security Act. For plan years beginning on or after January 1, 2027, a formulary must include in a preferred position each covered generic drug whose wholesale acquisition cost is less than that of its reference drug, and at least two covered biosimilar biological products whose wholesale acquisition cost is less than that of their reference biological product. The plan sponsor may not impose limits on access to these required generics or biosimilars, such as prior authorization or step therapy, that are more restrictive than those imposed on the reference drug or reference biological product, or that otherwise limit availability of the generic or biosimilar relative to the reference product. The section also defines key terms: 'covered biosimilar biological product,' 'covered generic drug,' 'preferred position' (meaning a more favorable formulary tier with lower patient out-of-pocket costs than the reference product), 'reference biological product,' 'reference drug,' and 'wholesale acquisition cost.'