Thanks to the Inflation Reduction Act, Medicare is better than ever and seniors will pay no more than $35 per month on insulin. President Biden and Democrats in Congress worked tirelessly to lower health care costs for seniors who have worked hard their whole lives. Too many seniors on fixed incomes have been kept at night worried about paying the bills — gas, groceries, medicines and more. This $35 cap helps millions of insulin users on Medicare afford the medicines they need to stay alive. Before the passage of the Inflation Reduction Act, too many diabetic seniors had to skip doses because of the high costs. Now thousands more seniors are able to fill their prescriptions for insulin each month. While taking insulin as prescribed reduces the likelihood of costly complications such as vision loss, heart disease, and kidney disease.
This is just the beginning: In 2025, seniors’ total drug costs will be capped at $2,000 per year and, in 2026, new savings from Medicare’s drug price negotiation will take effect. Together, these provisions will save seniors thousands of dollars on prescription drugs. And while the Inflation Reduction Act addressed the insulin affordability crisis for seniors, Democrats in Congress are also working to extend that cap so no American will pay more than $35/month for their insulin.
WHAT THE INFLATION REDUCTION ACT’S $35 INSULIN CAP DOES FOR SENIORS WITH DIABETES
Makes Insulin Accessible and Affordable For Seniors. In 2020, there were more than 3.2 million insulin users on Medicare Part D, with nearly 1.7 million purchasing their insulin without low-income subsidies. On average, seniors with Medicare Part D who are not receiving subsidies pay an average of $572 every year for this life saving medication — an unthinkable sum for many on fixed incomes. Under the Inflation Reduction Act, insulin copays for seniors on Medicare are now capped at $35 each month.
Thousands More Seniors Are Filling Their Insulin Prescriptions. The Inflation Reduction Act’s cap on insulin copays has led to increases in the total number of insulin prescriptions filled for Medicare beneficiaries. A study from the USC Schaeffer Center for Health Policy & Economics and University of Wisconsin–Madison found that following the cap’s enactment in January 2023, the number of insulin fills among Medicare Part D enrollees increased from 519,588 to 523,564 per month.
Rural Seniors Are Able to Access Affordable and Quality Care. According to a 2018 study, rural Americans are 17 percent more likely to suffer from diabetes than urban Americans. Diabetes risk factors are higher in rural areas than their urban and suburban counterparts as they have limited access to health care providers, fewer transportation options to receive care, and higher rates of being uninsured. These seniors are forced to stop taking their medication or cut doses in half. Diabetics suffer severe effects such as numbness in feet and nerve damage in the eyes when they stop taking doses as prescribed. Patients who suffer chronic complications can expect to pay upwards of an additional $650 per year. The insulin cap provision in the Inflation Reduction Act vastly improves the lives of millions of these vulnerable insulin users.
Americans Of Color Are Disproportionately Affected By Diabetes. Deaths related to diabetes are three times more likely among people of color than their white counterparts. Over 12 percent of Americans of color experience diabetes due to a combination of genetic, socioeconomic, and environmental risk factors. 11.8 percent of Hispanic adults have diabetes and are 50 percent more likely to develop type 2 diabetes over the course of their lifetime than their white counterparts. Racial and ethnic minority populations are also at a higher burden of diabetes-related complications, such as kidney disease, blindness, and worse glycemic control. Despite the higher risk of complications, Americans of color are less likely to receive recommended preventive care and annual screenings, largely as a result of systemic access barriers to this care. Americans of color spend upwards of $10,000 a year on diabetes-related costs.
Americans Of Color Skip, Ration, Or Delay Insulin Doses At Higher Rates Than Their White Counterparts. With rates of uninsurance 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. Black adults also continue to be the hardest hit when it comes to affording their prescription drugs and paying medical bills. The Inflation Reduction Act’s insulin cap is promoting health equity by expanding access and increasing affordability for diabetic seniors of color so much so that the prevalence of skipping doses is already beginning to fall.
REPUBLICANS ARE FIGHTING TO KEEP INSULIN PRICES HIGH
Republicans Blocked Insulin Cap for Millions of Americans. As the final negotiations were being made on the Inflation Reduction Act, Republicans in the Senate unified together to make sure that the $35 insulin cap was not universal. 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. An additional 21 million insulin users of all ages would have benefited from this universal program, including the nearly 300,000 young people under 20 who are diagnosed with diabetes. 1 in 5 people with private insurance pays 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. The Affordable Insulin Now Act, which will build upon the gains of the Inflation Reduction Act, is supported widely by Democrats but has been continually shot down by Republican legislators.