Key facts
- Bipartisan support is growing in the Senate for legislation to cap out-of-pocket insulin costs.
- The proposed cap for insulin costs is $35 for individuals with private health insurance.
- House Republicans are divided on the specifics of a potential "Reconciliation 3.0" bill.
- Disagreements exist over funding priorities and policy inclusions in the House bill.
- Eli Lilly supports efforts to lower patient out-of-pocket expenses for insulin.
- Concerns exist about potential premium increases if insulin costs shift to insurance pools.
- Some Republicans favor reforms to pharmacy benefit managers over direct price controls.
Bipartisan support is growing in the Senate for legislation that would cap out-of-pocket insulin costs for individuals with private health insurance at $35. This development comes as House Republicans are divided on the specifics of a potential "Reconciliation 3.0" bill. Significant policy disputes and disagreements over funding priorities are hindering progress on the House bill, despite some optimism about reaching an agreement on offsets.
Pharmaceutical companies, such as Eli Lilly, have voiced support for efforts aimed at lowering patient out-of-pocket expenses for insulin. However, concerns persist regarding the potential for premium increases if the costs are shifted to broader insurance pools. Some Republicans are exploring reforms to pharmacy benefit managers as an alternative approach to direct price controls on insulin.