Will Democrats’ New Insulin Price Cap Survive in the Senate?
Health Care

Will Democrats’ New Insulin Price Cap Survive in the Senate?

Lucy Nicholson/Reuters

The Build Back Better Act passed by the House last week would cap out-of-pocket costs for insulin at $35 a month starting in 2023, lowering the cost of the vital diabetes treatment for millions of people covered by Medicare or private insurance plans.

As the Senate prepares to take up — and, likely, to revise — the legislation, Senate Majority Leader Chuck Schumer (D-NY) over the weekend touted the insulin provision and warned Republicans against trying to nix the new cap.

“We are here today to tell the GOP to lay off! Do not try to attempt to kill this provision,” Schumer said at a press conference in New York. “Ten years ago insulin was cheap and easy and accessible. But all of a sudden, it’s gone up 12%, 15%, 17% a year, so now it’s as high as $600. And this is not a drug on patent. This is not one of those things that’s protected by patent. So there’s no reason the cost should be so high.”

Schumer said that he would do everything he can to keep the provision in the bill.

The background: Insulin has been available for nearly a century, but its price has doubled or tripled over the past decade, according to a bipartisan Senate report release early this year. Those surging prices have put insulin front and center in efforts to tackle high drug prices, with lawmakers in both parties looking to limit what patients pay for it.

“House Republicans have an alternative to Democrats’ drug pricing measure, which includes a monthly $50 cap on insulin and its supplies after Medicare patients hit their deductibles,” The Washington Post’s Rachael Roubein notes. “In the Senate, the top-ranking Republican lawmakers on the chamber’s health panels have a bill that includes making permanent a pilot project giving those on Medicare the option to get a voluntary prescription drug plan where insulin only costs $35 a month.”

The politics: “Curbing insulin costs is politically popular – and Democrats seem aware that Republicans could anger voters by challenging such caps,” Roubein writes, adding that Republicans have not yet detailed which of the Build Back Better bill’s health care provisions they may challenge.

The bottom line: While Republicans remain opposed to the Build Back Better package as a whole, Roubein reports that the key question now may be whether the Senate parliamentarian nixes the insulin cap as violating the budget reconciliation rules Democrats are using to pass the legislation without GOP support. Until that verdict comes down, Democrats are looking to publicize their cap and score some political points. “If Republicans want to defend higher insulin prices going into an election year, that’s a win for Democrats,” one Democratic aide told Roubein.