There’s been a LOT of information in the news recently about the cost of insulin. And while this is obviously important and of interest to your diabetic clients, it can be difficult to keep it all straight – what changes have merely been proposed and which ones have actually passed? As agents, it’s important to stay informed about these changes so we can answer our clients’ questions and let them know what to expect.

The Inflation Reduction Act and Insulin Pricing

The Inflation Reduction Act was signed into law August 16, 2022. This was a massive bill with far-reaching effects, but one of the most talked-about provisions aimed at curbing the rising cost of prescription drugs, including insulin. In addition to the media attention, the insulin price cap has received widespread support from the American public; however, it is important to note that it doesn’t help everybody.

Medicare Beneficiaries and Insulin Price Cap

For diabetic Medicare beneficiaries, the insulin price cap is particularly significant. According to Forbes, starting this year, diabetic beneficiaries will pay no more than $35 for insulin. This makes insulin more accessible and affordable for diabetic seniors living on a fixed income.

The Insulin Pricing Compromise – No Cap for those Without Medicare

The Inflation Reduction Act originally included language that also would have capped insulin prices for everyone with health insurance. However, as reported by CBS News, Senate Republicans blocked this provision, leading to a compromise in which the cap was removed. This means that the law, while still providing some benefits, does not go as far as initially proposed in addressing the high cost of insulin for all Americans with individual or group health insurance.

Challenges for Uninsured Americans

The Inflation Reduction Act also does not help those without health insurance. NBC News highlights the fact that uninsured Americans with diabetes will not benefit from the insulin price cap, emphasizing the critical role health insurance plays in accessing life-saving medications like insulin.

President Biden's Call for Nationwide Insulin Price Cap

Healthline reports that President Biden called for a $35 cap on insulin for all Americans with diabetes in his 2023 State of the Union address, recognizing the financial burden faced by millions. This call to action likely influenced pharmaceutical companies like Eli Lilly to reconsider their pricing practices.

Eli Lilly's Decision to Cap Insulin Costs

In response to the Inflation Reduction Act and the Biden administration's call for a nationwide insulin price cap, pharmaceutical giant Eli Lilly announced that it would cut insulin prices by 70% and cap the cost of their insulin at $35 per month for people with commercial insurance and Medicare. This decision has been praised for potentially helping millions of Americans manage their diabetes more affordably.

To Learn More

For more information on President Biden's insulin cap initiative, check out the White House Fact Sheet, which details how the cap could benefit millions of Americans across the country. Additionally, you may want to read the HHS statement from Secretary Xavier Becerra on the administration's efforts to lower insulin costs for those in need.