Health Care Costs and Drug Policy

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.