Senate bill caps insulin costs at $35 for insured patients

What does this do?

This bill would cap out-of-pocket insulin costs at $35 per month for people with private health insurance, with no deductible, beginning in 2027. From 2028 onward, that cap could be lower if the plan's negotiated price comes in under $35. The bill also requires that rebates and discounts from drug manufacturers be passed fully to the health plan, not kept by middlemen, and it would make it harder to use legal petitions to delay cheaper generic or biosimilar insulin products.

Who does it affect?

People with private health insurance who use insulin would be directly affected by the cost cap. Uninsured people could also be helped through a grant program available in up to 10 states, along with a resource center and a 24/7 hotline connecting them to assistance programs.

Why does it matter?

Without a cap, out-of-pocket insulin costs under private insurance vary widely and can be much higher than $35 per month. Delays in approving lower-cost insulin versions can limit how many affordable options are available on the market.

What does it cost, and who pays?

• Up to $100M in grants over 5 years
• Covers up to 10 states
• Insulin capped at $35/mo for uninsured