Affordable Insulin Now Act

12/29/2022, 9:33 PM

Affordable Insulin Now Act

This bill limits cost-sharing for insulin under private health insurance and the Medicare prescription drug benefit.

Specifically, the bill caps cost-sharing under private health insurance for a month's supply of selected insulin products at $35 or 25% of a plan's negotiated price (after any price concessions), whichever is less, beginning in 2023.

The bill caps cost-sharing under the Medicare prescription drug benefit for a month's supply of covered insulin products at (1) $35 between October 1, 2022, and January 1, 2024; and (2) $35 or 25% of a plan's negotiated price, whichever is less, beginning in 2024. The bill provides funds for FY2022 for the Centers for Medicare & Medicaid Services (CMS) to implement the bill.

Currently, the CMS is testing a voluntary model under the Medicare prescription drug benefit (the Part D Senior Savings Model) in which the copayment for a month's supply of insulin is capped at $35 through participating plans. The model is set to expire on December 31, 2025.

Congress
117

Number
S - 3700

Introduced on
2022-02-17

# Amendments
0

Sponsors
+5

Cosponsors
+5

Variations and Revisions

2/17/2022

Status of Legislation

Bill Introduced
Introduced to House
House to Vote
Introduced to Senate
Senate to Vote

Purpose and Summary

Affordable Insulin Now Act

This bill limits cost-sharing for insulin under private health insurance and the Medicare prescription drug benefit.

Specifically, the bill caps cost-sharing under private health insurance for a month's supply of selected insulin products at $35 or 25% of a plan's negotiated price (after any price concessions), whichever is less, beginning in 2023.

The bill caps cost-sharing under the Medicare prescription drug benefit for a month's supply of covered insulin products at (1) $35 between October 1, 2022, and January 1, 2024; and (2) $35 or 25% of a plan's negotiated price, whichever is less, beginning in 2024. The bill provides funds for FY2022 for the Centers for Medicare & Medicaid Services (CMS) to implement the bill.

Currently, the CMS is testing a voluntary model under the Medicare prescription drug benefit (the Part D Senior Savings Model) in which the copayment for a month's supply of insulin is capped at $35 through participating plans. The model is set to expire on December 31, 2025.

Alternative Names
Official Title as IntroducedA bill to provide for appropriate cost-sharing for insulin products covered under Medicare part D and private health plans.

Policy Areas
Health

Potential Impact
Appropriations
Department of Health and Human Services
Digestive and metabolic diseases
Drug therapy
Employee benefits and pensions
Executive agency funding and structure
Health care costs and insurance
Health care coverage and access
Medicare
Prescription drugs

Comments

Recent Activity

Latest Summary3/25/2022

Affordable Insulin Now Act

This bill limits cost-sharing for insulin under private health insurance and the Medicare prescription drug benefit.

Specifically, the bill caps cost-sharing under private health insurance for a mon...


Latest Action2/17/2022
Read twice and referred to the Committee on Finance.