Congress members have proposed three bills in 2022 that aim to reduce the cost of insulin to consumers.
Insulin is used to treat diabetes, a health condition that changes how the body turns food into energy.
In 2018, 12% of Texans age 18 and older had diabetes, according to the most recent data from the Centers for Disease Control and Prevention. About 11% of those age 20 and older in Brazoria and Galveston counties had diabetes in 2019. This increased from about 9%-10% in 2018.
Meanwhile, how much it costs distributors to buy a product in bulk from manufacturers has fluctuated in recent years. The average wholesale cost for a dose of insulin in 2022 is $363 compared to $239 in 2020—the earliest data available from the Texas Department of State Health Services.
Wholesale cost does not reflect how much a person pays, as that cost is dependent on factors such as insurance plans, dosage amount and frequency, DSHS Press Officer Douglas Loveday said.
If any of the three bills pass, they would differ from legislation Gov. Greg Abbott signed in June 2021 that limits copays for a 30-day supply of insulin at $25 for Texans on state-regulated health plans, according to a June 2021 news release from the nonprofit American Diabetes Association.
Texas’ existing legislation—Senate Bill 837—does not offer the cap to individuals who are uninsured or those not on state-regulated health plans such as Medicaid; however, the new bills would provide a price cap on copays for those with private health insurance or Medicare, U.S. Rep. Al Green, D-Houston, said. None of these legislations cover the uninsured.
Stephen Habbe, vice president of state government affairs for the ADA, said that rising costs of insulin has become more of a problem.
“Accessibility to insulin due to affordability has been a major problem for millions of Americans, and the pandemic has exacerbated that problem,” he said.
Proposed changes
One of the three bills being debated in Congress is House Resolution 6833, better known as the Affordable Insulin Now Act, which would cap insulin prices at either $35 a month or 25% of a private insurance plan’s price—whichever is cheaper—and $35 for those who have Medicare. The House of Representatives passed the resolution in a 220-193 vote March 31, and it was received by the Senate on April 4.
Additionally, U.S. Sen. Raphael Warnock, D-Georgia, introduced companion legislation in the Senate on Feb. 17, Green said.
However, U.S. Rep. Troy Nehls, R-Richmond, was one representative who voted against the measure.
“This bill institutes a price control agenda that will cost the federal government an additional $11 billion ... while not addressing the cost of insulin for uninsured Americans,” Nehls said.
Deborah Kilroe, director of communications with the Congressional Budget Office, a federal nonpartisan agency, said the bill would increase federal spending annually by about $6.6 billion and decrease revenue by about $4.8 billion.
In an effort to compromise on the issue, U.S. Sen. Susan Collins, R-Maine, and U.S. Sen. Jeanne Shaheen, D-New Hampshire, introduced a bipartisan policy, according to an April 11 news release by Collins’ office. The policy, which is still receiving input in the Senate, would include encouraging insulin manufacturers to reduce the suggested retail price by ensuring insurance plans cannot collect rebates, which drive up drug costs.
“People with diabetes should be able to get the medication they need without having to choose between filling their prescription, paying rent or putting food on the table,” Habbe said.
Kelly Schafler contributed to this report.
