Nov 18, 2022 - Health

Time running out on insulin cost caps

Illustration of a syringe in a bottle of insulin with a clock face cap

Illustration: Sarah Grillo/Axios

An effort to lower the cost of insulin for privately insured patients faces long odds in the lame duck session, Axios' Peter Sullivan reports.

Why it matters: More than 1 million Americans have to ration insulin because of the cost, according to an October study in the Annals of Internal Medicine.

Between the lines: Sens. Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine) have introduced a bipartisan measure to lower insulin costs, but finding nine other Republicans to get to 60 votes has proven difficult.

  • There isn't a lot of time on the Senate floor before the end of the year, and congressional scorekeepers concluded the measure would cost about $23 billion over 10 years, adding hurdles.
  • "It will be a big lift because it’s an expensive policy and Republicans will have to bring 10 votes, which they weren’t able to do earlier this year," a Senate Democratic aide said.
  • Another path would be getting the bill into the year-end government funding package, something that Senate GOP Leader Mitch McConnell isn't likely to agree to.
  • Sen. Raphael Warnock has also made capping insulin costs a key issue, adding a political hurdle to getting Republican support, at least before the Dec. 6 runoff election in Georgia.

How it works: Democrats' Inflation Reduction Act will cap monthly out-of-pocket insulin costs to $35 for Medicare beneficiaries starting next year.

  • The Shaheen-Collins bill would go further by placing a similar cap on the private market, along with voluntary incentives for drug companies to lower the list price of insulin.
  • Many Republicans view the policy as interfering in the private market. Only 12 House Republicans voted for a $35 cap earlier this year.
  • Some advocates have called for the bill to do more to lower the overall price of insulin, not just cap patient out-of-pocket costs.
  • "For any meaningful possible health care agenda, you want to get it done now," said Leslie Dach, chair of the Democratic-aligned advocacy group Protect Our Care.

Yes, but: Senate Finance Committee Chairman Ron Wyden said he is going to go "all in" to push for action on insulin. And Democrats, after keeping their Senate majority, could also seek to pressure the GOP House next year.

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