HHS secretary pushes for more affordable insulin

DALLAS — Health and Human Services Secretary Xavier Becerra's visit to Texas was as much about the people who fall through the cracks of a new federal cap on insulin costs as it was about the patients who can now get the life-saving diabetes treatment for only $35.

“Here's the most important part of this new prescription drug pricing: You have to be a Medicare recipient for you to benefit. You have to be 65 years or older or you have to be an American who's disabled and qualifies for Medicare,” Becerra said. “All those other Americans still are strapped with the unfair negotiation, the unfair pricing that occurs.”

Becerra touted the Inflation Reduction Act, a 2022 law that caps a month's supply of Medicare-covered insulin at $35 and allows the federal health insurance program for seniors to negotiate prices with drug manufacturers, while on a panel about drug costs at the Baylor Scott & White Health and Wellness Center in South Dallas this week.

That cap is a win for some Americans who rely on insulin. In 2020, Medicare enrollees without low-income subsidies paid an average of $54 out of pocket for insulin, a 39 percent increase since 2007, according to Medicare data analysis from the Kaiser Family Foundation.

People under 65 are left somewhere in between.

Some private health insurance plans cover most or all of the cost of insulin, while other private plans still require patients to pay hundreds or thousands of dollars each year.

Senate Republicans blocked a $35 cap on out-of-pocket insulin costs for patients with private insurance that was included in the Inflation Reduction Act.

For the uninsured, the cost is even higher, which makes insulin affordability a particular issue in Texas, the state with the highest uninsured rate in the nation, according to the U.S. Census Bureau. It's an issue that likely will get worse in the coming months as Medicaid protections from the COVID-19 public health emergency declarations end.

A January survey of Medicare recipients found that out-ofpocket insulin costs of $35 or more per month was associated with a more than 61 percent lower likelihood of sticking to the medication. The effects of splitting or missing insulin doses can be detrimental to diabetes patients and eventually lead to kidney, eye and nerve damage.

“I write the prescription and I look it up and I'm hoping and praying that it's covered and affordable,” said Dr. Lydia Best, medical director at the Health and Wellness Center. “They call from the pharmacy or, worse yet, they wait until their next visit and say they couldn't afford it.”

Estella Savage, 74, found out she had diabetes when she was just 35 years old. For nearly four decades, Savage has had to navigate treating and managing the condition, which has cost her between $2,000 and $3,000 per year.

Savage's diabetes is now well controlled, thanks in large part to education and exercise programs organized through the Health and Wellness Center, located at the Juanita J. Craft Recreation Center. She joined Becerra's panel to share her own experience with accessing care for a chronic disease like diabetes.

“I want people to know that they can be helped, too,” she said.