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FACT SHEET: Universal $35 Insulin Copay Cap Will Benefit Millions Of Americans

By February 15, 2023No Comments

Congressional Republicans Stripped Universal $35 Insulin Cap From the Inflation Reduction Act

At the State of the Union, President Biden called for capping insulin costs for every American, not just people on Medicare. Since January 1, more than 3.2 million insulin users on Medicare have been eligible for a $35 insulin copay cap thanks to the Inflation Reduction Act. However, an additional 21 million insulin users, who are not on Medicare, were blocked from receiving these same benefits because of Republicans in Congress. Protect Our Care is highlighting the importance of lower insulin costs over the next two weeks and calling for finishing the job of the Inflation Reduction Act to make the $35 cap universal. 

BY THE NUMBERS

  • 21 million insulin users would benefit from a universal $35 insulin cap.
  • Nearly 1 in 5 adults skip, ration, or delay insulin doses to save money.
  • 23.2 Percent of Black Americans ration insulin compared to 16 percent of their white and Hispanic counterparts. 
  • A month’s worth of insulin costs over $1,000 on average.
  • A universal insulin cap is overwhelmingly supported by 88 percent of Americans.

Over 20 Million Americans Would Benefit From A Universal $35 Insulin Copay Cap. While there are 49 million seniors on Medicare who are eligible for $35 insulin copay cap, 3.2 million were insulin users in 2020. If Congress passes legislation to make the $35 insulin copay cap universal, an additional 21 million insulin users of all ages would benefit. 1 in 5 people with private insurance pay more than $35 per month and, for people who are uninsured or have poor coverage, insulin can cost up to $1,000 per month. A striking 14 percent of insulin users spend catastrophic amounts, or at least 40 percent of their income, on insulin.

Americans Of Color Disproportionately Skip, Ration, Or Delay Insulin Doses Compared To Their White Counterparts. Americans of color are more likely than their white counterparts to experience diabetes due to biological, socioeconomic, and environment risk factors. With rates of uninsured also being highest among people of color, these insulin users are at a higher risk of skipping, rationing, or delaying insulin doses. Nearly 24 percent of Black Americans ration insulin compared to 16 percent of their white and Hispanic counterparts.

Data For Progress Finds Strong Support For Capping Insulin Copays. An overwhelming 88 percent of Americans, including 87 percent of Republicans, support Congress taking action to cap insulin copays for those with private insurance at $35 per month.

Republicans Prevented A Universal Insulin Cap From Passing Under The Inflation Reduction Act. In August 2022, during the negotiation phases of the Inflation Reduction Act,  Republicans stripped the universal insulin cap from the final language of the bill. In a country where 80 percent of diabetics have had to go into debt in order to pay for insulin, this type of action by Republicans reeks of the influence of Big Pharma.