February 28, 2022
WASHINGTON, D.C. – U.S. Senator Angus King (I-Maine) is introducing legislation to cap the out-of-pocket cost of insulin nationwide – building on a Maine law that caps out-of-pocket insulin costs for those with state-regulated commercial insurance. The Affordable Insulin Now Act will require Medicare and private plans to make sure no patients’ out-of-pocket costs for insulin exceed $35 per month – the same cap as Maine – lowering costs for insulin users, saving families thousands of dollars a year, and helping more people afford the life-sustaining medication. Over one-hundred thousand Maine people have diabetes, and is one of only a few states nationwide that caps out-of-pocket insulin costs – according to one nationwide estimate, diabetics spend close to $6,000 annually on insulin alone, meaning the legislation could cut costs for diabetics nationwide by as much as ninety percent.
“No one should ever have to choose between paying for life-sustaining medication or putting food on the table – but with the steadily rising cost of insulin, far too many people across the country have been forced to make this heartbreaking choice,” said Senator King. “In Maine, we’ve helped many families avoid this tough choice by capping the out-of-pocket cost of insulin for many insurance holders at $35 a month. This has proven to be an effective, important step to help thousands of Maine families afford the essential medication and save their hard-earned money for life’s other important necessities. The Affordable Insulin Now Act would build on Maine’s success nationwide – capping the out-of-pocket costs of insulin to the same $35 a month for users on both Medicare and private insurance. This was not a partisan issue in Maine, and it should not be a partisan issue nationwide; the bill would save and extend lives, lower costs for working Maine families, and represent a significant step towards more affordable healthcare for Americans.”
Under the Affordable Insulin Now Act, private group or individual plans would be required to cover one of each insulin dosage form (vial, pen) and insulin type (rapid-acting, short-acting, intermediate-acting, and long-acting) for no more than $35 per month. Medicare Part D plans, both stand-alone drug plans and Medicare Advantage drug plans, would be required to charge no more than $35 for whichever insulin products they cover in 2023 and 2024, and for all insulin products beginning in 2025. This would implement a nationwide law similar to the one Maine passed in 2020 that caps out-of-pocket insulin costs for those with state-regulated commercial insurance patients at $35 per month.
Senator King has been a champion for affordable, accessible healthcare, and prevention healthcare policies across the board – including by pushing to lower prescription drugs costs and advocating for the long-term success of the Affordable Care Act. He lauded the decision of the Supreme Court to uphold the law last year, and pushed for stronger federal assistance to reduce deductibles and out-of-pocket health care expenses for American families. King has also introduced the Primary and Behavioral Health Care Access Act, which would require private insurance plans to cover three annual primary care visits and three annual outpatient mental health or outpatient substance use disorder treatment visits, without charging a copayment, coinsurance, or deductible-related fee.