**The Affordable Insulin Now Act Would Require Insurers to Cap Patients’ Out-of-Pocket Costs for Insulin at $35 Per Month**
(Washington, DC) – U.S. Senators Jeanne Shaheen (D-NH), Co-Chair of the Senate Diabetes Caucus, Maggie Hassan (D-NH), a member of the Senate Finance Committee, joined Senator Reverend Raphael Warnock (D-GA) in introducing legislation to require Medicare plans and private group or individual plans to cap patients’ out-of-pocket costs for insulin at $35 per month. This will lower costs for insulin users and save money for hardworking Granite Staters and Americans—many of whom are paying exorbitantly from their own pockets for insulin and other diabetic treatments.
“Millions of Americans live with diabetes and millions more are at risk of developing this life-threatening disease – they shouldn’t break the bank affording the medication they need. As Co-Chair of the Senate Diabetes Caucus, I’m proud to help introduce legislation to cap the cost of insulin at $35 per month so more patients can lead healthy lives,” said Shaheen. “I’ll continue working to combat sky-high prescription costs as we work to ultimately find a cure to diabetes.”
"As insulin prices skyrocket, Granite Staters have shared with me their struggle to afford life-saving insulin products,” said Senator Hassan. “It is their stories that have inspired this legislation, which caps out-of-pocket spending for an insulin product at $35 per month – another commonsense way that we can help lower costs for Granite State families.”
According to one estimate, diabetics spend close to $6,000 annually on insulin alone. Nearly 26 million Americans are afflicted with diabetes and another 79 million have pre-diabetes, a condition that is known to progress to diabetes without early intervention, according to the Centers for Disease Control and Prevention (CDC). The CDC estimates that if current trends continue, one in three Americans will have diabetes by 2050. Diabetes is the seventh leading cause of death in the United States and can lead to many other chronic diseases and conditions, such as blindness and kidney failure. As one of the most expensive chronic diseases, diabetes costs the American health care system billions of dollars each year. Overall, one in every ten health care dollars is spent on diabetes and its complications, and one in every three Medicare dollars is spent on the condition.
Under the Affordable Insulin Now Act, private group or individual plans would be required to cover one of each insulin dosage form (vial, pen) and insulin type (rapid-acting, short-acting, intermediate-acting, and long-acting) for no more than $35 per month. Medicare Part D plans, both stand-alone drug plans and Medicare Advantage drug plans, would be required to charge no more than $35 for whichever insulin products they cover in 2023 and 2024, and for all insulin products beginning in 2025.
The bill text is available here.
As Co-Chair of the Senate Diabetes Caucus, Shaheen has worked to increase awareness of the threats posed by diabetes, invest in research and improve access to treatment options. Shaheen has consistently held insulin manufacturers, insurers and pharmacy benefit managers accountable for the skyrocketing cost of life-saving insulin. Last year, Shaheen and Collins led a bipartisan group of Senators to reintroduce the Expanding Access to Diabetes Self-Management Training Act, which would expand Medicare coverage for diabetes self-management training (DSMT) sessions, where diabetes educators help train Medicare patients on how to manage their glucose, maintain a healthy weight, eat healthy foods, manage their insulin levels and improve general care for their diabetes.
Senator Hassan is committed to lowering health care costs for Americans. Senator Hassan led successful, bipartisan efforts with Senator Bill Cassidy (R-LA) to help end the practice of surprise medical billing, which is now in effect. Senators Hassan and Cassidy also successfully passed into law their bipartisan legislation to enhance education about biosimilar drug products in an effort to increase competition and lower drug costs. Additionally, the American Rescue Plan, which Senator Hassan helped pass into law, is helping to lower health care costs for many Granite Staters who purchase health care coverage through the Affordable Care Act marketplaces.
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