The U.S. House passed a bill late last week limiting cost-sharing for insulin under private health insurance and Medicare Part D.
H.R. 6833 caps cost-sharing under private health insurance for a month’s supply of selected insulin products at $35 or 25% of a plan’s negotiated price (after any price concessions), whichever is less, beginning in 2023. The bill also caps cost-sharing under the Medicare prescription drug benefit for a month’s supply of covered insulin products at $35 beginning in 2023.
Senate Majority Leader Chuck Schumer (D-N.Y.) said on the Senate floor on March 16, “I expect that we will consider next steps soon on proposals already presented” to address rising prescription drug costs. “For millions of Americans who rely on insulin to manage their diabetes, this is a crisis that should compel the Senate to act,” he said.
“The cost of insulin has skyrocketed,” Schumer tweeted on March 23. “This is a crisis. The Senate will vote on a bill to fix this.”
The Senate returns from its spring recess on April 25. The way forward on insulin in the chamber is unclear. Sen. Ralph Warnock (D-Ga.) has introduced a companion bill to H.R. 6833. Sen. Susan Collins (R-Maine) meanwhile told Kaiser Health News on March 30 that she and Sen. Jeanne Shaheen (D-N.H.) have an outline for a bill that “tackles the broader issue of the high list price for insulin, and the conflicts of interests that occur in the chain from manufacturer to the consumer buying it at the pharmacy counter.”
While drug pricing advocates generally applaud the effort to tackle the burden of high insulin costs, they have been urging Congress to make sure that the legislation would address the actual price of diabetes medicine rather than just providing financial support and relieving co-payments for patients.
Whichever bill arises, it is unclear if Senate Democrats can persuade 10 Republicans to join with them to pass the legislation.