East Bay Times

Biden's price cap for insulin is not clear-cut

- By Will Weissert

Rarely a day goes without President Joe Biden mentioning insulin prices. He promotes a $35 price cap for the medication for Americans on Medicare, and his reelection team has flooded swing-state airwaves with ads mentioning it.

All that would seemingly add up to a sweeping political and economic impact. The reality is more complicate­d.

As his campaign tries to emphasize what it sees as an advantage over presumptiv­e Republican nominee Donald Trump, Biden often overstates what those people who are eligible for the price cap once paid for insulin. It's also not clear whether the number of Americans being helped will be enough to help sway November's election, even in the most closely contested states that could come down to a few thousand votes.

“It is about political signaling in a campaign much more than it is about demonstrat­ing for people that they benefit from the insulin cap,” said Drew Altman, president and CEO of KFF, a nonprofit that researches health care issues. “It is a way to make concrete the fact that you are the health care candidate.”

Many who are benefiting from the price cap already were getting insulin at reduced prices, were already Biden supporters, or both. Others who need reduced-price insulin, meanwhile, cannot get it because they do not have Medicare or private health insurance.

Biden's campaign is emphasizin­g the president's successful efforts to reduce insulin prices and contrastin­g that with Trump, who first ran for president promising to lower drug prices but took limited action in office.

“It's a powerful and tangible contrast,” said Biden campaign spokespers­on Charles Lutvak. “And it's one we are campaignin­g on early, aggressive­ly and across our coalition.”

Reductions across the U.S.

Roughly 8.4 million people in the United States control their blood sugar levels with insulin and more than 1 million have Type 1 diabetes and could die without regular access to it. The White House says nearly 4 million older people qualify for the new, lower price.

The price cap for Medicare recipients was part of the Inflation Reduction Act, which originally sought to cap insulin at $35 for all those with health insurance. When it passed in 2022, it was scaled back by congressio­nal Republican­s to apply only to older adults.

The Biden administra­tion also has announced agreements with drugmakers Sanofi, Novo Nordisk and Eli Lilly, to cap insulin co-payments at $35 for those with private insurance. They account for more than 90% of the U.S. insulin market. But Biden says constantly that many people used to pay up to $400 monthly, which is an overstatem­ent. A Department of Health and Human Services study released in December 2022 found that people with diabetes who were enrolled in Medicare or had private insurance paid an average of $452 annually, not monthly.

The high prices the president cites mostly affected people without health insurance. But the rates of the uninsured have fallen to record lows because of the Obama administra­tion's signature health care law and the Biden White House's aggressive efforts to ensure those eligible to enroll are doing so more frequently.

One of Biden's key issues

Geoff Garin, a pollster for Biden's campaign, said the insulin cap is one of the president's highest performing issues. He said the data was “clear, consistent and overwhelmi­ng.”

Rich Fiesta, executive director of the Alliance for Retired Americans, which has endorsed Biden, called the insulin cap a strong issue for the president among older voters.

“For the persuadabl­es . ... drug costs are a very important factor,” said Fiesta, whose group has 4.4-million members and advocates.

The president's approval ratings on health care are among his highest on a range of issues, but still only 42% of U.S. adults approve of Biden's handling of health care while 55% disapprove, according to a February poll from The Associated Press and the NORC Center for Public Affairs Research.

KFF found in its own poll in December that that 59% of U.S. adults trust the Democratic Party to do a better job addressing health care affordabil­ity issues compared to 39% for Republican­s, even if only 26% of respondent­s in the same poll said they knew about the insulin price cap.

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