Bipartisan Senate Bill Revives $35 Monthly Insulin Cap for Commercial Plans
A bipartisan group of senators has reintroduced the INSULIN Act of 2026, a bill that would cap many insured Americans’ monthly insulin costs at $35 and extend some protections to uninsured patients, giving the long-stalled measure new momentum ahead of the 2026 midterms. Co-authored by Sens. Jeanne Shaheen, D-N.H., Susan Collins, R-Maine, Raphael Warnock, D-Ga., and John Kennedy, R-La., the bill would bar group and individual health plans from applying deductibles to selected insulin products and, starting in plan year 2027, limit out-of-pocket charges to $35 for a 30‑day supply; from 2028, patients would pay the lesser of $35 or 25% of the drug’s negotiated net price. Collins says the legislation is designed not only to impose patient caps but also to rein in pharmacy benefit managers and spur biosimilar competition so that lower list prices actually reach consumers, while revisions pushed by Kennedy and Warnock aim to create a mechanism for uninsured Americans to access capped-price insulin as well. The effort builds on a 2022 law that set a $35 insulin cap for Medicare beneficiaries and dovetails with President Trump’s broader drug‑pricing agenda, including his “Most Favored Nation” policy and the new TrumpRx portal, which currently lists Eli Lilly’s Insulin Lispro at $25 a month. Online, diabetes advocates are highlighting stories of patients rationing insulin and backing federal caps, while free‑market critics are warning that Congress risks entrenching list‑price games and cost‑shifting if it does not simultaneously tackle manufacturer and PBM incentives.
📌 Key Facts
- The INSULIN Act of 2026 is co-authored by Sens. Shaheen, Collins, Warnock and Kennedy and revives a 2023 proposal.
- The bill would bar deductibles on selected insulin products and cap out-of-pocket costs in group and individual plans at $35 per 30-day supply starting in plan year 2027, shifting in 2028 to the lesser of $35 or 25% of negotiated net price.
- Sponsors say the bill also targets pharmacy benefit managers, encourages biosimilar competition, and now includes provisions to help uninsured Americans access affordable insulin.
- The push aligns with Trump’s drug‑pricing agenda and follows a 2022 law imposing a $35 insulin cap for Medicare beneficiaries, while TrumpRx is advertising some insulin at $25.
📊 Relevant Data
In the US, the prevalence of diagnosed diabetes among adults is 15.7% for American Indian or Alaska Native, 12.2% for non-Hispanic Black, 11.8% for Hispanic, 9.7% for non-Hispanic Asian, and 7.1% for non-Hispanic White individuals.
Diabetes in America: Prevalence, Statistics, and Economic Impact — American Diabetes Association
In 2023, uninsured rates among US adults were 22% for Hispanic, 13% for other races, 8% for Black, 5% for White, and 3% for Asian individuals, compared to 8% overall.
Percent uninsured — Peterson-KFF Health System Tracker
Without insurance, monthly out-of-pocket costs for insulin in the US range from approximately $200 to $600 for patients using multiple vials or pens.
In a 2025 survey at the Yale Diabetes Center, 37% of patients reported rationing insulin due to high costs, pharmacy shortages, or insurance delays, with 24.1% specifically due to cost.
Insulin Rationing Persists Despite Policy Changes, Study Shows — Yale School of Medicine
Genetic studies show that a 5% higher European ancestry is associated with a 29% lower risk of incident diabetes among Black individuals in the US.
Genetic European Ancestry and Incident Diabetes in Black Individuals — American Heart Association Journals
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