Rep. Bera Votes to Cap Out-of-Pocket Costs for Insulin at $35 Per Month

Press Release

Representative Ami Bera, M.D. (D-CA) today voted for H.R. 6833, the Affordable Insulin Now Act, bipartisan legislation to cap out-of-pocket costs for insulin at no more than $35 per month in Medicare Part D and commercial health insurance.

"As a doctor, I know firsthand that far too many Americans are burdened with skyrocketing prescription drugs costs," said Representative Bera, who served as Chief Medical Officer for Sacramento County. "In fact, Americans pay ten times more for insulin compared to our peer nations, forcing families to choose between paying for lifesaving medication and making a car payment, not saving for their children's college education, or worse. The Affordable Insulin Now Act is long overdue action that ensures affordable access to insulin for more than 37 million Americans who have diabetes, including over 7 million Americans who rely on insulin to maintain their health. I will always fight to lower prescription drugs costs for Sacramento County families."

Between 2014 and 2019, insulin costs rose by 54% in our country, forcing tens of millions of Americans to choose between lifesaving medication and other basic needs. Among those with private coverage, 1 in 5 people who take insulin have out-of-pocket costs of more than $35 per month

Beginning in 2023, the Affordable Insulin Now Act requires private health plans to cover at least one of each type and dosage form of insulin and caps cost-sharing for a 30-day supply at the lesser of $35 or 25 percent of a plan's negotiated price. The bill also requires all Medicare prescription drug plans to cap cost-sharing for insulin at no more than $35.

- Among individuals with private insurance, half would save at least $19 per month and a quarter would save at least $42 per month. Individuals who buy their own insurance will experience the most savings.
- This bill is paid for by delaying the implementation for one year of the Rebate Rule that was published by the Office of the Inspector General of the Department of Health and Human Services on November 30, 2020.

As one of 17 physicians in Congress, Representative Bera has been a leader in efforts to lower the costs of prescription drugs.

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