CULPEPER STAR-EXPONENT, CLINT SCHEMMER

On Thursday, the U.S. House of Representatives passed a bill capping the out-of-pocket cost of insulin at $35 per month for insured patients.

A bill backed by 7th District Rep. Abigail Spanberger, the proposal has cleared the House and awaits action by the U.S. Senate.

The Affordable Insulin Now Act, approved 232-193 by a bipartisan majority of House members, would help millions of Americans afford this critical treatment. More than 630,000 Virginians are living with Type 1 or Type 2 diabetes, Spanberger’s office said.

The cost of the four most popular kinds of insulin has tripled over the last decade, and out-of-pocket costs keep rising. Since the COVID-19 pandemic began, 25 percent of people with diabetes have rationed insulin to lower the cost of their care.

The Affordable Insulin Now Act is supported by various national organizations, including the American Diabetes Association and JDRF (Juvenile Diabetes Research Foundation).

Before the vote on the bill she cosponsored, Spanberger spoke on the House floor about capping insulin costs and the Virginians who will benefit—such as her constituent, Joshua Davis.

“The Affordable Insulin Now Act would finally make sure that every affected child, teenager, family member, every American can afford the insulin that they need,” the Central Virginia lawmaker said. “People living with diabetes do not have the choice of whether to purchase insulin or not—they depend on it to stay alive.

“… I am proud to cosponsor this legislation to make sure that no American is skipping life-saving doses of their insulin or making choices between whether they take their insulin or put food on the table.”

The two-term 7th Congressional District legislator noted that Joshua Davis, a 13-year-old Virginian with Type 1 diabetes accompanied Dr. Jill Biden to the president’s State of the Union Address earlier this year. The Midlothian youth was diagnosed at 11 months old. His father also suffers from diabetes.

In February, Joshua introduced President Joe Biden at an event in Culpeper on lowering prescription drug costs. For years, the Davis family have been strong advocates for people with diabetes in Virginia and across the country.

Spanberger has focused on lowering drug costs for Virginia families since first being elected to Congress. As a candidate and a lawmaker, she has heard about the insulin’s high price from individuals and families.

Experts say the legislation would provide significant relief for privately insured patients with skimpier plans and for Medicare enrollees facing rising out-of-pocket insulin costs. Some could save hundreds of dollars annually. All insured patients would get the benefit of predictable monthly costs for insulin. But the bill would not help the uninsured.

Spanberger’s broader work to lower prescription drug prices won the hearty endorsement on Feb. 10 of President Joe Biden, who flew to Culpeper to visit Germanna Community College’s Daniel Technology Center—with Health and Human Services Secretary Xavier Becerra—and tout her years-long efforts.

“Since I first ran for Congress, this issue has been top-of-mind for my constituents,” Spanberger said then. “They are outraged that in the United States of America, they have to pay 10 times as much—or more—as what patients in other countries pay for the same medication. For our neighbors with common health conditions like diabetes, heart disease or cancer, I consistently hear about how skyrocketing drug prices are making it harder to stay ahead—and harder to plan for the future.”

Biden was the first U.S. chief executive to visit a Germanna campus in the college’s 52-year history. Germanna serves seven counties in Central Virginia and the city of Fredericksburg.

Spanberger is seeking re-election this fall to a third term, as eight Republicans compete to become their party’s challenger in the high-profile race.

The insulin cost cap is part of an election-year push by Democrats for price curbs on prescription drugs as inflation rises, The Associated Press reported.

The Affordable Insulin Now Act will serve as a political vehicle to rally Democrats and force Republicans who oppose it into uncomfortable votes ahead of the midterms, the AP said.

For the legislation to pass Congress, 10 Republican senators would have to vote in favor.

“If 10 Republicans stand between the American people being able to get access to affordable insulin, that’s a good question for 10 Republicans to answer,” said Rep. Dan Kildee, D–Mich., a cosponsor of the House bill. “Republicans get diabetes, too. Republicans die from diabetes.”

Public opinion polls have consistently shown support across party lines for congressional action to limit drug costs.

But Rep. Cathy McMorris Rodgers, R–Wash., complained the legislation is only “a small piece of a larger package around government price controls for prescription drugs.”

Critics say the bill would raise premiums and fails to target pharmaceutical middlemen seen as contributing to high list prices for insulin.

Sen. Chuck Grassley, R-Iowa, said Democrats could have a deal on prescription drugs if they drop their bid to authorize Medicare to negotiate prices. “Do Democrats really want to help seniors, or would they rather have the campaign issue?” Grassley said.

If enacted into law, the insulin bill would take effect in 2023.

In addition to a similar $35 cap on insulin, the bill would authorize Medicare to negotiate prices for a range of drugs, including insulin. It would penalize drugmakers who raise prices faster than inflation and overhaul the Medicare prescription drug benefit to limit out-of-pocket costs for enrollees.

The idea of a $35 monthly cost cap for insulin has a bipartisan pedigree. The Trump administration had created a voluntary option for Medicare enrollees to get insulin for $35, and the Biden administration continued it.

In the Senate, Republican Susan Collins of Maine and Democrat Jeanne Shaheen of New Hampshire are working on a bipartisan insulin bill. Georgia Democratic Sen. Raphael Warnock has introduced legislation similar to the House bill, with the support of Sen. Majority Leader Chuck Schumer of New York.

Collins says she’s looking for a way to help uninsured people through her bill.

About 37 million Americans have diabetes, and an estimated 6 million to 7 million use insulin to keep their blood sugars under control. It’s an old drug, refined and improved over the years, that has seen relentless price increases.

Steep list prices don’t reflect the rates insurance plans negotiate with manufacturers. But those list prices are used to calculate cost-sharing amounts that patients owe. Patients who can’t afford their insulin reduce or skip doses, a strategy born of desperation, which can lead to serious complications and even death.

Economist Sherry Glied of New York University said the market for insulin is a “total disaster” for many patients, particularly those with skimpy insurance plans or no insurance.

“This will make private insurance for people with diabetes a much more attractive proposition,” Glied said of the Affordable Insulin Now Act.