This legislation, effective January 1, 2027, mandates that private group health plans and health insurance issuers provide coverage for selected insulin products without applying any deductible. For these products, plans cannot impose cost-sharing exceeding the lesser of $35 or 25 percent of the negotiated price per 30-day supply. This cost-sharing will count towards any applicable deductible or out-of-pocket maximum, though plans may impose higher cost-sharing for out-of-network providers. The bill defines "selected insulin products" to include at least one of each dosage form, such as vial, pump, or inhaler, and each different type of insulin, including rapid-acting, short-acting, and long-acting. Furthermore, the Department of Health and Human Services is directed to establish a program to support health care providers and pharmacies in furnishing discounted insulin to uninsured individuals . Under this program, qualifying entities will be reimbursed by the Secretary for the difference between an individual's out-of-pocket cost and $35, ensuring uninsured individuals pay no more than $35 for a 30-day supply of insulin products.
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Health
Affordable Insulin Now Act of 2026
USA119th CongressS-4512| Senate
| Updated: 5/13/2026
This legislation, effective January 1, 2027, mandates that private group health plans and health insurance issuers provide coverage for selected insulin products without applying any deductible. For these products, plans cannot impose cost-sharing exceeding the lesser of $35 or 25 percent of the negotiated price per 30-day supply. This cost-sharing will count towards any applicable deductible or out-of-pocket maximum, though plans may impose higher cost-sharing for out-of-network providers. The bill defines "selected insulin products" to include at least one of each dosage form, such as vial, pump, or inhaler, and each different type of insulin, including rapid-acting, short-acting, and long-acting. Furthermore, the Department of Health and Human Services is directed to establish a program to support health care providers and pharmacies in furnishing discounted insulin to uninsured individuals . Under this program, qualifying entities will be reimbursed by the Secretary for the difference between an individual's out-of-pocket cost and $35, ensuring uninsured individuals pay no more than $35 for a 30-day supply of insulin products.