Congressman Cleaver Votes to Cap Out-of-Pocket
Insulin Costs at $35 per Month

(Washington, D.C.) – In late March, U.S. Representative Emanuel Cleaver, II (D-MO) voted in favor of H.R. 6833, the Affordable Insulin Now Act, which would cap out-of-pocket costs for insulin at no more than $35 per month in Medicare Part D and commercial health insurance. With 1 in 4 Americans who rely on insulin admitting to having cut back or skipped doses due to cost, this legislation ensures vital and affordable access to life-saving medication for more than 37 million Americans who have diabetes. The bipartisan bill was passed by the House of Representatives with a vote of 232-193 and will now go to the U.S. Senate.

“Right now, Americans pay more than 10 times the price for insulin compared to other high-income countries due to nothing more than lack of competition and corporate greed,” said Congressman Cleaver. “With passage of the Affordable Insulin Now Act, we can prevent Big Pharma from ripping off the tens of millions of Americans who have diabetes and are in need of life-saving medication, ensuring these individuals can get their prescriptions at an affordable price. As hardworking Missouri families continue to feel the pain of global inflation, I remain committed to lowering costs wherever possible for consumers—and lowering prescription drug costs is a very good place to start.”

From 2014-2019, the average retail price of insulin rose by 54 percent. According to the American Diabetes Association, 25 percent of Americans with diabetes who depend on insulin have admitted to cutting back or skipping doses due to cost, risking severe health consequences and even death. A recent study showed that out-of-pocket costs for insulin among all users averaged $64 in 2017, nearly double what the out-of-pocket costs would be with the Affordable Insulin Now Act.

To lower costs on Americans who rely on insulin, the Affordable Insulin Now Act would:

• Require Medicare Part D plans and commercial health insurance plans to cover insulin, ensuring that plans cover at least one of each type and dosage form of insulin

• Cap out-of-pocket costs at no more than $35 per month, requiring private insurance to cap cost-sharing at the lesser of $35 or 25 percent of a plan’s negotiated price, and requiring all Medicare prescription drug plans to cap cost-sharing for insulin at no more than $35 and

• Be completely deficit-neutral by delaying the implementation of the Rebate Rule that was published the Office of the Inspector General of the Department of Health and Human Services on November 30, 2020.

“At a time when the American people are begging Congress to work together to pass legislation that will lower costs on working class families, I hope that somehow, someway we can find 10 Republicans in the Senate to support this common sense proposal. Failure to do so would be a dereliction of duty,” said Congressman Cleaver.

Source U.S. Representative Emanuel Cleaver, II (D-MO) Washington DC Office