The insulin cap previously was included in the Democrats' "Build Back Better" legislation but rescued to become a standalone bill.
The U.S. House of Representatives has passed legislation that would cap the out-of-pocket cost of insulin at $35 per month, lowering drug costs for more than seven million diabetes patients. Introduced by three Democrats, the Affordable Insulin Now Act passed mostly along party lines.
"No American should have to choose between paying for life-saving insulin and other basic necessities like food and rent," Rep. Angie Craig of Minnesota, one of the bill's co-sponsors, said in a statement. "And yet, today, all across the country, patients are risking their own lives by rationing doses or skipping treatments entirely due to the skyrocketing cost of their medications."
Indeed, costs to treat diabetes and other life-threatening ailments have skyrocketed in recent years. 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. According to the Centers for Disease Control and Prevention, 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.
As TheHill.com reports: "Under the bill, Medicare beneficiaries would pay no more than $35 for each 30-day insulin prescription. Cost-sharing for beneficiaries in private plans would be limited to the lesser of either $35, or 25 percent of the health plan's negotiated price for a 30-day prescription. … But while it would save consumers thousands of dollars at the pharmacy, the bill does not lower the overall price of insulin and does not solve the problem of skyrocketing drug prices. Instead, it would shift more of the cost onto insurers and employers."
"The premium impact is going to be substantial, and this isn't the way to address the high cost of insulin," an insurance industry lobbyist told Politico.com on the condition of anonymity. "But all these Democrats want this win."
The insulin cap previously was included in the Democrats' "Build Back Better" legislation but rescued to become a standalone bill after it appeared the original sweeping legislation was in danger.
Meanwhile, in the Senate, Sen. Raphael Warnock (D-Ga.) has introduced a bill that also would cap out-of-pocket insulin costs at $35 per month. TheHill.com notes that Warnock's bill "may be combined with bipartisan legislation from Sens. Jean Shaheen (D-N.H.) and Susan Collins (R-Maine) that seeks to lower the underlying cost of insulin through a yet-to-be-defined process."
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