Federal lawmakers have introduced bipartisan legislation that would cap patients’ insulin costs at $35 per month.
Sens. Jeanne Shaheen, D-N.H., Susan Collins, R-Maine, Raphael Warnock, D-Ga., and John Kennedy, R-La., introduced the bill March 25.
The $35 monthly price cap would apply to most patients with private and employer-sponsored insurance beginning in 2027. The legislation would require group and individual market health plans to waive deductibles and limit cost-sharing to no more than $35 for a 30-day supply of selected insulin products, defined as at least one of each dosage form and type of insulin.
In 2028, the cap would shift to either $35 or 25% of the drug’s negotiated price, whichever is lower. Plans would be restricted from imposing most prior authorization and utilization management requirements, with limited exceptions, and cost protections may not apply to out-of-network coverage.
The bill would also establish a five-year pilot program in 10 states to expand access to low-cost insulin for uninsured individuals, as well as fund a national resource center and hotline to help patients find and enroll in assistance programs.
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