Many health plans would have to cover certain insulin before the deductible starts. Patients would pay no more than $35 for a 30-day supply, or 25% of the plan's negotiated price, whichever is less. The rules would also apply to catastrophic plans.
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Affordable Insulin Now Act is a House bill in committee. The latest recorded action: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Latest action on H.R. 6255: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Who this affects: This bill mainly affects people with diabetes who use insulin and get coverage through private insurance, an employer plan, or a catastrophic plan. It could matter most for people who now pay full price until they meet a deductible or face high copays at the pharmacy. Health insurers, employer plans, and pharmacy benefit managers, which are the companies that manage drug benefits, would also have to change plan rules and contracts to follow the new caps.
Why this matters: This bill matters because insulin can be expensive at the pharmacy counter even for people who already have insurance. It would make costs for selected insulin more predictable and, for some patients, lower. It also stops many plans from making people pay the full deductible first for those products. At the same time, the bill does not control the list price of insulin, so its effect on premiums, other benefits, or total spending is not clear from the bill alone.
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