Bill To Cap Insulin Cost To $35 Per Month Passed By U.S. House


Those who suffer from diabetes know how expensive the disease is. Others are lucky enough to get these for free with their medical coverage plan. Others, not so much. They have to pay for their maintenance out of pocket.

Hence, the government officials of the U.S. have decided to put their heads together to cater to the needs of those who need insulin. The bill that was recently passed will be able to assist them in such a huge way because it aims to help cut down costs.

The members of the U.S. House of Representatives have passed the Build Back Better Act.  This focuses on the most sweeping nationwide measure to date to lower out-of-pocket co-pays for insulin supply to those who need it badly.

The ADA has been heavily promoting their national co-pay cap. This is applicable to all Medicare beneficiaries, individuals on commercial insurance, and those who are covered by other group health plans. The House-passed legislation is there to create an out-of-pocket co-pay limit of $35 per month for insulin costs.

Just days prior to the House vote, around a total of 15,000 American Diabetes Association advocates needed to contact their representatives through the ADA’s Engagement Platform. Their goal was to heavily promote support for co-pay caps. The move was also made to allow the government to negotiate drug prices with those who manufactured the medicines.

This is such an integral step because to this very day, the diabetes patients have been feeling the impact of the extremely high rise in the average cost of insulin. In reality, the price of the drug was nearly three times the original cost. This happened between 2002 and 2013. Because of the steep prices, around one in four insulin-dependent Americans had been forced to ration their insulin supply, which could be detrimental to their health. “This vote is a victory for millions of Americans facing unaffordable insulin and hope for lowering other drug costs. House leaders have taken a bold and urgent step this week,” Lisa Murdock, Chief Advocacy Officer for the ADA, shared.


Their Brand New Hope

In the journey to acquire the House consideration of the insulin co-pay cap, the ADA has promoted efforts around the country. They had been there advocating for co-pay caps that have already been established in 20 states and in the District of Columbia. “These states paved the way for this week’s historic action in the House,” said Murdock. “We thank those members of the House of Representatives who supported a national insulin co-pay cap, building on the efforts of state leaders before them. Together, these leaders are working to ensure that millions of people with diabetes will be able to afford their insulin and will not have to skip doses or ration because they don’t have enough money to pay for this life-saving drug.”

The bill that has been passed will also be able to provide benefits for people who have been diagnosed with diabetes. One of which is that their increased health insurance premium tax credits will be extended. These have been created through the Affordable Care Act and it has also increased through the latest COVID-19 relief legislation. Moreover, this has also added funding for states to somehow provide relief for the costs accumulated in running Medicaid programs.

ACA plans and Medicaid have become very vital for those who have diabetes, but they have also been disproportionately affected, economically and through untimely health impacts, by the recent worldwide pandemic. Hence, the gap coverage measures are very important for the community right now because they heavily rely on these plans. They need to find ways to cover their insulin, devices, and supplies costs.

“We now urge the Senate, as it considers the Build Back Better legislation, to move forward with a measure that also adopts these critical provisions that can make insulin more affordable, and health coverage more accessible, to 34 million people living with diabetes today,” Murdock said.

The proposal should be brought to light soon. According to ABC, “Republicans have largely opposed the measure and refer to the bill as ‘government priced fixing’ that could lead to higher premiums for customers and exorbitant costs for insurers.” On the other hand, the Senate is made up of a majority of Democrats, which could be favorable for the Bill. Essentially, we all can hope that this will work for everyone involved and affected by the changes.