Affordable Insulin Now Act

The "Affordable Insulin Now Act" aims to significantly reduce out-of-pocket costs for certain insulin products by amending the Public Health Service Act, the Internal Revenue Code, and the Employee Retirement Income Security Act. Beginning January 1, 2026, group health plans and health insurance issuers will be required to provide coverage for selected insulin products . A core provision of this bill is the elimination of deductibles for these selected insulin products. Furthermore, it establishes a cap on cost-sharing, ensuring that patients pay no more than the lesser of $35 per 30-day supply or 25 percent of the negotiated price , after accounting for all price concessions. These cost-sharing payments will also be applied towards an individual's annual deductible and out-of-pocket maximums. The bill defines "selected insulin products" as at least one of each dosage form and type of insulin, chosen by the plan or issuer, and clarifies that while mandating these cost-sharing limits, plans are not obligated to cover out-of-network insulin or prevent higher cost-sharing for such services. Additionally, it amends the Patient Protection and Affordable Care Act to ensure catastrophic health plans cover selected insulin products before the annual deductible is met, while clarifying that the insulin deductible exemption does not affect a plan's actuarial value.