Warnock-Reed bill would require insurers to cap patient out-of-pocket costs for insulin at $35 per month

 WASHINGTON, DC -- In an effort to cap the out-of-pocket cost of insulin for Rhode Islanders and Americans, U.S. Senator Jack Reed today joined with U.S. Senator Reverend Raphael Warnock (D-GA) in introducing The Affordable Insulin Now Act.  This new bill will require Medicare plans and private group or individual plans to cap patients’ out-of-pocket costs for insulin at $35 per month. This will lower costs for insulin users and save money for hardworking Americans—many who are paying exorbitantly from their own pockets for insulin and other diabetic treatments. According to one estimate, diabetics spend close to $6,000 annually on insulin alone. This is all while costs for insulin are going up and manufacturers of the drug are pocketing more revenue from insulin sales than in prior decades.

“Too many Georgians have or know someone who has diabetes, and too many live with the burden of treating this chronic condition with critical insulin that’s costing them more and more,” said Senator Reverend Warnock. “At the same time, special corporate interests are seeing record profits, while everyday people are seeing record prices for drugs like insulin they need to live. I’ve long been focused on strengthening access to affordable health care and lowering costs for Georgians, and that’s why I am proud to lead the effort in the Senate to cap patients’ out-of-pocket costs for insulin. Georgians should never have to choose between paying for life’s basic essentials or life-preserving medicines.”

“Millions of Americans need insulin to survive.  But the price of this drug continues to skyrocket for consumers.  This legislation will help fix the insulin cost problem by capping patient out-of-pocket costs for insulin at $35 per month and allow Americans to access to life-saving prescription drugs,” said Senator Reed.

Under the Affordable Insulin Now Act, private group or individual plans would be required to cover one of each insulin dosage form (vial, pen) and insulin type (rapid-acting, short-acting, intermediate-acting, and long-acting) for no more than $35 per month. Medicare Part D plans, both stand-alone drug plans and Medicare Advantage drug plans, would be required to charge no more than $35 for whichever insulin products they cover in 2023 and 2024, and for all insulin products beginning in 2025.

According to the Health Care Costs Institute, insulin prices nearly doubled from 2012 to 2016, with the average price for a 40-day supply of insulin increasing from $344 to $666 during that span. According to the U.S. Centers for Disease Control and Prevention (CDC), medical costs and lost work and wages for people with diagnosed diabetes total $327 billion yearly, and the American Diabetes Association has asserted that diabetics account for $1 of every $4 spent on health care in the U.S. At the same time, a 2021 bipartisan staff report from the Senate Finance Committee found that “[insulin] manufacturers are retaining more revenue from insulin than in the 2000s,” and that “the amount of revenue pharmaceutical manufacturers are retaining from insulin has risen.”

In addition to Senators Warnock and Reed, the Affordable Insulin Now Act is cosponsored by U.S. Senators Chuck Schumer (D-NY), Dick Durbin (D-IL), Richard Blumenthal (D-CT), Michael Bennet (D-CO), Tammy Baldwin (D-WI), Maggie Hassan (D-NH), Mark Kelly (D-AZ), Debbie Stabenow (D-MI), Chris Van Hollen (D-MD), Mazie Hirono (D-HI), Amy Klobuchar (D-MN), and Chris Murphy (D-CT).

The legislation is also endorsed by: Protect Our Care; American Diabetes Association, American Federation of State, County and Municipal Employees (AFSCME); American Federation of Teachers, Community Catalyst, Public Citizen, and Social Security Works.