Aug 7, 2022 - Politics & Policy

Insulin price cap for private insurers pulled from reconciliation bill

Illustration of a syringe pulling from a vial with a hundred dollar bill as a label.

Illustration: Aïda Amer/Axios

Senate Republicans blocked the $35 cap on out-of-pocket spending on insulin for patients enrolled in private insurance in the reconciliation package.

Why it matters: The drug costs eight times more in the U.S. than 32 other high-income nations, according to a 2020 study commissioned by the Health and Human Services Department.

What we're watching: The change to the climate, tax and health care package came during the amendment process that allows any senator to force a vote on proposed tweaks to the measure.

  • Seven Republicans voted with Democrats to keep the insulin cap in the bill, but that was not enough to overcome the 60-vote threshold.
  • The Republicans argued that the provision violated the rules of reconciliation after the Senate parliamentarian ruled that it is not primarily related to the federal budget.

Between the lines: Even though the $35 cap for the private insurers has been stripped from the package, Democrats are hoping to preserve the $35 insulin cap for patients on Medicare.

The big picture: Capping out-of-pocket insulin costs — a narrow sliver of President Biden's stalled Build Back Better package — has been a priority for Democrats, particularly ahead of this year's midterms.

  • It's also captured the attention of a few Republicans, leading to some bipartisan efforts to craft legislation.
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