Congress has a bipartisan way to reduce insulin costs
It may seem counterintuitive, but we see hopeful signs that lawmakers in Washington can pass legislation to lower the cost of insulin, for everyone who needs it, not just those who are 65 and older.
You may have read that Republicans in the U.S. Senate blocked efforts to include a broad insulin price cap in the Inflation Reduction Act, which Senate Democrats passed over the weekend. The bill does cap insulin costs at $35 a month for those 65 and older who are on Medicare.
This is a simplistic telling of events that leaves out some important context — context which shows that passing a price cap may still be possible.
As reported by The Hill, one of the few publications to delve into the details of the weekend vote, the Senate parliamentarian ruled that a proposal to cap insulin at $35 a month for most of those who used it could not be included in the bill. That’s because it would impact prices in the private market, something the parliamentarian determined is outside the scope of the reconciliation process, which allows senators to approve such measures by a majority vote.
Rather than accept the parliamentarian’s ruling, Democratic leaders insisted on a vote to override the parliamentarian, likely to put Republicans on record as appearing to oppose the insulin price cap. To override the parliamentarian, 60 votes were needed. The vote was 57 to 43, with all the objections coming from Republicans.
Still, seven Republicans voted to override the parliamentarian’s ruling and to allow the cap to go forward. They were: Sen. Susan Collins, Sens. Bill Cassidy and John Kennedy of Louisiana, Josh Hawley of Missouri, Cindy Hydesmith of Mississippi, and Lisa Murkowski and Dan Sullivan of Alaska.
We don’t want to try to predict future Senate action, but with this much support, it seems like a clean bill to cap insulin costs has a decent chance of passage.
“During the highly partisan reconciliation process, seven Republican senators voted for an amendment to extend a $35 insulin price cap to private insurance. This show of support makes me hopeful that we can get at least 10 Republican votes if we take up the comprehensive bill Sen. Jeanne Shaheen and I developed that would limit out-of-pocket costs for privately insured patients taking insulin as well as reduce the list price of the drug, protecting uninsured patients who pay cash for their insulin,” Collins said in a statement. “Based on my individual meetings with my colleagues to discuss our bill, I believe and am hopeful that we will receive the support of more than 10 Republican senators.”
In June, Collins and Shaheen, a Democrat from New Hampshire, unveiled legislation to reduce insulin costs. Their bill would limit insulin costs, through deductibles, co-pay or co-insurance to no more than $35 a month, for all insured users of the medication, not just seniors. Their bill would also help ensure patient access to insulin by restricting prior authorization, step therapy or other medical management requirements that limit beneficiary use of the medication.
More than 37 million Americans live with diabetes, which is one of the leading causes of death in the United States, claiming over 100,000 lives in 2021. Diabetes is also the most expensive chronic condition in the nation, costing a total of $327 billion per year, according to a press release from the senators. Between 2012 and 2016, the average list price of insulin nearly doubled.
“It is my intention to bring the Insulin Act to the floor of the Senate very soon,” Senate Majority Leader Chuck Schumer said on the Senate floor on June 22. “And, it ought to pass this chamber expeditiously. Reducing the price of insulin is not a Democratic issue or a Republican issue. It’s something that affects millions of Americans in every city and every state.”
On Monday, Schumer pledged to bring a $35 insulin price cap to the floor again soon. The Collins-shaheen bill offers a bipartisan way to do what Democrats hoped to accomplish for more insulin users through the Inflation Reduction Act.