Insulin price caps for the general population could become part of a year-end deal. Photo: Spencer Platt/Getty Images
Backers of new curbs on insulin costs have been talking about reconciling competing Senate bills for months. But although there are signs of life, there's still no consensus on a way forward.
Driving the news: Key senators told Axios there is not yet agreement on a compromise measure between the two leading bills: one from Sens. Jeanne Shaheen and Susan Collins, and the other from Sens. Raphael Warnock and John Kennedy.
- Shaheen told Axios the four have been talking, but "the issue is around how you cover the uninsured." She didn't go into detail but suggested that finding a way to win GOP support for a mechanism was an issue.
- Kennedy said he thinks Senate Majority Leader Chuck Schumer will ultimately have to step in and merge the two bills. "We've tried" to come up with a compromise, he said.
- "What I expect to happen is for Sen. Schumer to do a shotgun wedding between the two bills and include the insulin provision, which would also provide coverage to uninsured, in the larger PBM bill," Kennedy said.
- Finding a payfor is also key to winning more GOP support, as Warnock's office indicated. "The senator and his team are speaking to numerous Republican offices who are ideologically supportive of the $35 universal cost cap and are eager to see a pay for as they evaluate signing onto our bipartisan legislation," Warnock's office told Axios.
The big picture: The insulin bill would be focused around a $35-per-month out-of-pocket cap for people with private insurance and is expected to be packaged in with action on PBMs, which multiple committees have been working on.
- The Inflation Reduction Act capped Medicare recipients' monthly insulin costs at $35. President Biden's FY2024 budget called for extending the cap to all Americans, and an Axios-Ipsos poll this year found overwhelming backing.
- Big U.S. insulin manufacturers have committed to lowering the cost of their products — a move that can save them money by lowering the amount they'd have to rebate Medicaid.
Between the lines: Savings from the PBM sections of a compromise bill could help pay for the insulin legislation.
- The natural landing place for such a move would be a year-end spending package, but it is unclear what that will look like given the broader disarray on appropriations, particularly in the House, which doesn't even have a speaker.
The bottom line: Though the outlook may be unclear and this effort has dragged on for a long time, senators are keeping the fires burning.
- Collins and Shaheen told a Washington Post Live event Thursday morning that their bill is broader than just the $35 cap and also includes provisions on passing rebates on insulin through to plan sponsors and encouraging biosimilars.
- Warnock and Kennedy's bill is more narrowly focused on the $35 cap, though it also includes language directing HHS to set up a program for the uninsured to get insulin.
- The Senate also has plenty else on its plate at the moment, including Israel and Ukraine funding. Asked if she had heard from Schumer recently on floor timing, Shaheen said: "Not recently, because of the world events."
- Kennedy said he also didn't know about timing, adding "But it's on our minds and I think it will be a matter of weeks."
