WASHINGTON — Senate Democrats were able to keep the price of most insulins at $35 a month thanks to the Cut Inflation Act they passed on Sunday and sent to the House. But millions of diabetics will pay even more after Republicans changed the measure to exclude private insurers.
The Senate congressman ruled on Sunday that the cap on private insurers did not comply with the rules of reconciliation, the budget process that allowed Democrats to push the bill through without the support of Republicans in a Senate as well. Split.
Republicans pushed to limit the cap to Medicare only, a vote that took 60 senators to overcome. Seven Republicans sided with Democrats to keep the private insurer provision in place, but it failed — 57-43 — meaning the cap won’t apply outside of Medicare assuming the House passes The law project.
Republicans who voted against the private insurer cap argued that the Senate should decide the cap separately from the broader reconciliation bill, which includes a variety of climate and tax measures in addition to pharmaceutical prices. .
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The seven Republicans who voted to keep the private insurer cap were Susan Collins of Maine, Cindy Hyde-Smith of Mississippi, Josh Hawley of Missouri, John Kennedy and Bill Cassidy of Louisiana, and Lisa Murkowski and Dan Sullivan of Alaska.
While the cap for Medicare beneficiaries is still a victory Democrats have long been calling for, letting private insurers continue to decide what they charge is a setback for members of the diabetes community who are advocating for control of bard scale price.
President Joe Biden called for the $35 cap in his State of the Union address in March, and senators twice this session have sought caps on insulin costs. Sen. Raphael Warnock, D-Ga., sponsored a bill in February, and Sen. Susan Collins, R-Maine, and Sen. Jeanne Shaheen, DN.H., led a bipartisan effort in June targeting at the both Medicare and private insurers. None of these bills reached the floor.
Out-of-pocket cap prevails for Medicare
One in three Medicare beneficiaries has diabetes, with more than 3.3 million people dependent on insulin. According to Carmen Balber, executive director of Consumer Watchdog, a nonprofit consumer advocacy organization, the savings from that $35 co-pay cap could amount to hundreds of dollars a year.
“Diabetes is a common disease in the United States and insulin is a drug that consumers must take for life. Allowing the pharmaceutical industry to manipulate the prices of a drug like insulin that keeps diabetics in life is inadmissible,” Balber said.
A Yale University study found that 14% of insulin users spend 40% or more of their income on insulin.
Insulin prices in the United States have skyrocketed over the past few decades, while prices in other countries have remained stable. A 2018 study by the Rand Corporation found that the average insulin cost per unit in the US was $98.70, compared to $12 in Canada and $7.52 in the UK.
“It’s pure capitalism,” Balber said.
“Because the insulin is so needed, they are able to charge more for it. beyond the pace of inflation, and get away with it,” she says.
Majority Leader Sen. Chuck Schumer said at a press conference after the bill passed that the Cut Inflation Act takes an important step to reduce the prices of prescription drugs, including including insulin, after years of trying.
“Ever since I came to the Senate in 1999, we’ve been trying to do that, and eventually we got there in a major way,” Schumer said.
He called Medicare’s insulin cap a “big, big win for millions of seniors” who rely on Medicare.
Insulin users under private insurance no longer have a cap
Nearly a third of people insured by a small employer and a fifth insured by large employers pay more than $35 a month for insulin, according to an analysis by the Kaiser Family Foundation.
“There are a lot of middle- and low-income people covered by private insurance, and they’re not going to benefit from it,” said Richard Frank, senior research fellow in economic studies at the Brookings Institute.
“Perhaps when the insulin problem is not part of something larger and as partisan as the Cut Inflation Act was, then clearer thinking might prevail, and a draft stand-alone bill that solves the rest of the insulin problem could potentially pass,” he said.
In a tweet Sunday, Sen. Ron Johnson, R-Wis. — who voted with Republicans against the cap — said the amendment amounted to a “Democrat ‘gotcha’ vote.”
“In reality, the Dems wanted to break Senate rules to pass the insulin price cap instead of going through a regular order. They put that in a bill that wasn’t allowed, all of that for the show,” he tweeted on Sunday.