Effects of Biden’s cap not clear-cut

WASHINGTON — Rarely a day goes without President Joe Biden mentioning insulin prices.

He promotes a $35 price cap for the medication for Americans on Medicare — in White House speeches, campaign stops and even at events unrelated to health care. His reelection team has flooded swing-state airwaves with ads mentioning it, in English and Spanish.

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 the presumptive Republican nominee, former President 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.

“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 were already 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 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 spokesman Charles Lutvak. “And it’s one we are campaigning on early, aggressively, and across our coalition.”

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 has also 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 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 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.

So, in effect, one of the administration’s policy initiatives is undermining the economic argument for another.