A proposal to cap insulin costs for those with private insurance would not be part of broader climate and health legislation Senate Democrats will pass Sunday after Republicans moved to bar the bill.
The Democrats’ proposal needed 60 votes to survive, but only seven Republicans voted “yes” to the 50 Democrats in the chamber.
The high price of insulin is one of the most famous and extreme examples of high drug costs troubling Americans. According to research by the RAND Corporation, the cost of insulin in the US is five to ten times higher than in other economically developed countries. In a recent survey of people with diabetes who take insulin, nearly 80% said it causes them financial difficulties.
This also includes those who are privately insured but bear a large part of the costs directly due to the high co-payments in their drug insurance. Democrats had hoped to achieve this by capping those co-payments at $35 a month, and Saturday’s version of the Inflation Reduction Act included such a provision.
Patty Murray (D-Wash) said, “Not only will it save money, it will save lives.” “It shouldn’t be hard to vote.”
But to pass legislation with a simple majority, Democrats use a “budget voting process” instead of the traditional 60 required to overcome a filibuster. The Arbitration Code stipulates that every legal provision must have a direct, significant impact on the federal budget. The Senate legislature, which advises the chamber on procedural matters, ruled that the insulin cap for private insurance did not meet that requirement.
Democrats went ahead and included the provision in their bill anyway, effectively challenging Republicans to remove it — a courage 43 Republicans accepted when they objected to its inclusion on procedural grounds. According to the rules of the Senate procedure, this was enough to prevail.
Trying to lower the cost of insulin wasn’t a total failure. The IRA law has a similar provision that caps insulin for Medicare beneficiaries at $35 per month. Republicans have not challenged that measure because lawmakers decided it met reconciliation requirements.
And the insulin cap is one of several IRA provisions aimed at lowering the cost of living in law. Others include the federal government’s power to negotiate the price of certain drugs in Medicare and a $2,000 annual cap on out-of-pocket drug spending in the program.
But insulin supply was one of the few that would hit privately insured people directly. Another proposal, designed to help those with private health insurance and limit annual increases in drug prices in commercial plans, was also viewed negatively by lawmakers — and Democrats later tried to include it. Didn’t.
The insulin cap is popular, with 61% of prospective voters strongly supporting it, according to a Data for Progress poll, and Democratic leaders wasted no time attacking Republicans for their vote on Sunday.
Ron Wyden (D-Ore.) said, “After years of tough talks about acquiring insulin makers, Republicans have once again succumbed to the heat of Big Pharma.”
Republicans sought to stop Democratic attacks on insulin supply by proposing their own amendment aimed at making insulin available in federal health centers to be paid for by receiving Obamacare funds. But Democrats blocked that measure, arguing it was insufficient.
This probably won’t be the last time the Senate will address the high cost of insulin. Democratic leaders have vowed to vote on a bipartisan bill penned by Sens Jean Shaheen (DNH) and Susan Collins (R-Main) that would also cap insulin costs.
Collins was one of them seven Republican senators who voted with Democrats to put an insulin cap in the IRA. The others were Sens Bill Cassidy and John Kennedy (La.), Josh Hawley (Mon.), Cindy Hyde-Smith (Miss.), and Lisa Murkowski and Dan Sullivan (Alaska).
But the bipartisan Collins-Shaheen bill would have to go through the regular order, which means it would require 60 votes — and even with those seven Republicans, three would still be under the line.
Democrats are on course to pass the bill on Sunday, and their peers in the House of Representatives are expected to approve it and send it to President Joe Biden’s desk on Friday. This includes historic investments to combat climate change and other measures to reduce healthcare costs.
As for insulin, a new opportunity is the kind of government action California is at the forefront of. Last month, Democratic Gov. Gavin Newsom announced that the state would use $100 million of its budget to manufacture and distribute inexpensive insulin to residents.
Such measures can also help uninsured people who are not included in the IRA insulin offering for private insurance.
This is an evolving story. Please check again for updates.