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.
AppropriationsDepartment of Health and Human ServicesDigestive and metabolic diseasesDrug therapyEmployee benefits and pensionsExecutive agency funding and structureHealth care costs and insuranceHealth care coverage and accessMedicarePrescription drugs
Affordable Insulin Now Act
USA117th CongressS-3700| Senate
| Updated: 2/17/2022
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 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.
AppropriationsDepartment of Health and Human ServicesDigestive and metabolic diseasesDrug therapyEmployee benefits and pensionsExecutive agency funding and structureHealth care costs and insuranceHealth care coverage and accessMedicarePrescription drugs