Us Congress 2023-2024 Regular Session

Us Congress Senate Bill SB1269

Introduced
4/25/23  

Caption

INSULIN Act of 2023 Improving Needed Safeguards for Users of Lifesaving Insulin Now Act of 2023

Impact

The legislation has significant implications for healthcare regulations and will likely reshape how insurance plans handle insulin coverage. The bill reinforces requirements on health plans regarding the avoidance of prior authorization or other restrictions on insulin products, thereby streamlining access for patients. By removing deductibles and capping costs, the law seeks to alleviate the financial strain on users and ensure that cost does not hinder access to this essential medication. Additionally, it could influence pharmaceutical pricing strategies in the long run.

Summary

SB1269, also known as the Improving Needed Safeguards for Users of Lifesaving Insulin Now Act of 2023, aims to reduce the price of insulin and enhance patient protections related to insulin costs. The bill mandates that, starting January 1, 2024, health plans must provide coverage for selected insulin products without imposing any deductibles and limit cost-sharing to a maximum of $35 for a 30-day supply. This initiative directly targets the financial barriers faced by individuals who require insulin to manage diabetes, making the medication more accessible.

Contention

While the bill has received broad support, it has also faced scrutiny and debate among stakeholders. Some critics express concerns about the fiscal impact on insurance companies and the potential for increased premiums across the board. Others advocate that while the bill addresses a pressing need for affordable insulin, it may create challenges in balancing cost management for health insurers. The emphasis on transparency among pharmacy benefit managers is another point of contention, with the potential for conflicts arising from rebate structures that could affect the affordability of insulin.

Companion Bills

US SB1067

Related Ensuring Timely Access to Generics Act of 2023

US HB5372

Related Expanding Seniors' Access to Lower Cost Medicines Act of 2023

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