Legislation Limits Cost of Insulin for Seniors
On August 12, 2022, the House passed the Senate-approved Inflation Reduction Act–historic legislation that limits the cost of insulin for seniors enrolled in Medicare and extends the COVID-19 expansion of Affordable Care Act (ACA) health insurance premium tax credits, crucial financial assistance that spared millions of Americans from pandemic disruptions in their health care.
“The American Diabetes Association has been the leading organization advocating for copay caps for insulin, resulting in the enactment of these cost-sharing limits in 22 states and the District of Columbia,” said Lisa Murdock, chief advocacy officer for the American Diabetes Association (ADA). “While we have more work to do to expand this benefit to all people with diabetes who rely on insulin to survive, this first national copay cap is a significant step in the right direction and a potentially lifesaving policy change for seniors.”
“Having health insurance is the single strongest predictor of whether adults with diabetes have access to high-quality health care and are able to manage their diabetes,” said Dr. Robert Gabbay, the ADA’s chief scientific and medical officer. “Uninsured Americans who are at risk for diabetes and its complications are much less likely to receive a diagnosis, and if they do get a diagnosis, they still average 60 percent fewer office visits with a physician and experience 168 percent more hospital visits than their insured counterparts. The expansion of these ACA health insurance subsidies will literally save lives of people with diabetes.”
The Inflation Reduction Act also caps the cost of all prescription drugs at $2,000 per year for seniors who have Medicare Part D and allows Medicare to negotiate the price of some of the most expensive prescription drugs directly with drug manufacturers, reducing the cost of these often out-of-reach medications to seniors. $1 in every $3 spent on prescription drugs in the U.S. is spent on someone with diabetes, and this out-of-pocket cost limit will benefit people with diabetes who rely on more than just insulin to survive.
─ Source: American Diabetes Association