House passes legislation capping insulin costs to $35 a month, part of broader push to contain drug prices

WASHINGTON – The House of Representatives has passed legislation capping the monthly cost of insulin for insured patients at $35. This is part of an election-year push by Democrats for price controls on prescription drugs amid rising inflation.

Experts say the legislation, passed between 232 and 193 on Thursday, would mean significant relief for privately insured patients with tighter plans and for Medicare members who face rising costs for their insulin. Some could save hundreds of dollars annually, and all insured patients would benefit from predictable monthly insulin costs. The bill would not help the uninsured.

But the Affordable Insulin Now Act will serve as a political tool to rally Democrats and force opposing Republicans to an uncomfortable vote ahead of the midterms. For the bill to pass Congress, 10 Republican senators would need to vote in favor of it. Democrats admit they have no answer as to how that will happen.

“If 10 Republicans stand between the American people’s access to affordable insulin, that’s a good question for 10 Republicans to answer,” said Rep. Dan Kildee, D-Mich., a co-sponsor of the House bill. “Republicans get diabetes too. Republicans die from diabetes.”

MORE: Tips to save money as prescription drug prices soar

Opinion polls have consistently shown cross-party support for Congressional action to limit drug costs.

But Rep. Cathy McMorris Rodgers, R-Wash., complained that the legislation was just “a small part of a larger package around government price controls on prescription drugs.” Critics say the bill would increase premiums and does not target pharmaceutical middlemen who are seen as contributing to high insulin list prices.

Sen. Chuck Grassley, R-Iowa, said Democrats could reach a deal on prescription drugs if they drop their bid to authorize Medicare to negotiate prices. “Do the Democrats really want to help the elderly, or do they prefer the campaign theme?” said Grasley.

The insulin law, which would take effect in 2023, is just one provision of a much broader prescription drug package in President Joe Biden’s social and climate legislation.

In addition to a similar $35 cap on insulin, the Biden Act would authorize Medicare to negotiate prices on a range of drugs, including insulin. It would penalize drugmakers that increase prices faster than inflation and revise Medicare’s benefits for prescription drugs to limit out-of-pocket costs for participants.

Biden’s agenda passed the House of Representatives only to falter in the Senate because Democrats were unable to reach a consensus. Party leaders have not given up hope of restarting legislation and keeping drug price restrictions largely intact.

The idea of ​​a $35 monthly cost cap on insulin actually has bipartisan pedigree. The Trump administration had created a voluntary option for Medicare enrollments to receive insulin for $35, and the Biden administration continued it.

In the Senate, Maine Republican Susan Collins and New Hampshire Democrat Jeanne Shaheen are working on a bipartisan insulin bill. Democratic Georgia Sen. Raphael Warnock, with support from New York Senator Majority Leader Chuck Schumer, has introduced legislation similar to the House bill.

Stung by criticism that Biden’s economic policies are driving inflation, Democrats are redoubling efforts to show how they would help people deal with the costs. On Thursday, the Commerce Department said a key indicator of inflation rose 6.4% year on year in February, the biggest year-on-year rise since January 1982.

But experts say the home bill would help uninsured people who face the highest out-of-pocket expenses for insulin. In addition, diabetics often take other medications in addition to insulin. This is done to treat the diabetes itself, along with other serious health conditions often associated with the disease. Even legislation from the House of Representatives would not help with these costs. Collins says she’s looking for a way to help uninsured people through their bill.

About 37 million Americans have diabetes, and an estimated 6 to 7 million use insulin to help control their blood sugar. It is an ancient drug that has been refined and improved over the years, and its price has risen inexorably.

Steep list prices do not reflect the rates insurance plans negotiate with manufacturers. However, these list prices are used to calculate the co-payment amounts owed by patients. Patients who cannot afford their insulin reduce or skip the dose, a strategy born of desperation that can lead to serious complications and even death.

New York University economist Sherry Glied said the market for insulin is a “total disaster” for many patients, especially those with tight insurance plans or no insurance.

“This makes private insurance much more attractive for people with diabetes,” says Glied.

Copyright © 2022 by The Associated Press. All rights reserved. House passes legislation capping insulin costs to $35 a month, part of broader push to contain drug prices

Dais Johnston

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