For years, the soaring price of insulin has forced elderly Arizonans with diabetes to make painful choices—in some instances, forced to choose between health care and rent.
This is the result of a systemic problem: Americans pay 2.56 times more for prescription drugs than those in 32 other countries.
But now that’s changing.
Biden administration cuts prescription drug costs
Earlier this year, the Inflation Reduction Act began to ease the pressure of health-related expenses. Dramatic new price cuts will help up to 63,000 Arizona Medicare beneficiaries who depend on insulin to treat their diabetes.
Medicare recipients now need to pay no more than $35 a month for insulin—down from an average of $54.
In another major benefit, out-of-pocket costs for all drugs under Medicare Part D will be capped at $2,000 per year, beginning in 2025. That could help some 32,000 Arizona Medicare beneficiaries every year.
More cost-saving reforms on the way:
- Biden’s Inflation Reduction Act will cap costs for 10 other medications for Medicare recipients, beginning in 2026.
- 165,000 Arizonans who depend on these drugs are eligible for this relief.
- The 10 drugs, which treat illnesses including heart failure, blood clots, arthritis, and Crohn’s disease, represent the highest spending for drugs in Medicare Part D.
- Over the next four years, Medicare plans to tackle prices for up to 60 other drugs, with 20 more every year thereafter.
Harris’ next steps
Harris has released a number of policy priorities as part of her presidential platform that will build on the cost-saving measures that have been implemented during her time as vice president.
Some of what Harris has proposed include:
- Make temporary tax credits permanent. These credits currently save those insured through the ACA marketplace an average of $800 per year.
- Transparency requirements for pharmaceutical companies to reduce high prescription costs and limit price-gouging.
- Exempt medical debt from credit scores
- Universal cap on insulin to $35 per month
- Expand government negotiation of drug costs to cut prescription costs
Efforts curbed by Republican lawmakers
For now, the relief affects only older Americans. But Democrats want to extend it to all ages, so no one has to choose between staying healthy and housed and fed. House Democrats introduced the Affordable Insulin Now Act last year, which would have capped the price of insulin prescribed through private insurance and Medicaid at $35 a month.
It passed the House, with all four of Arizona’s Republican representatives—Andy Biggs, Paul Gosar, Debbie Lesko, and David Schweikert—voted against it. The proposal was later blocked by Senate Republicans.
Schweikert has repeatedly voted in line with the interests of the pharmaceutical industry to block efforts by Democratic lawmakers, including Arizona US Sen. Mark Kelly, to impose a universal insulin price cap.
If Medicare is paying for your insulin:
- Your bills should already be lower.
- The new cap kicked in for Part D (drugs) recipients in January and for Part B (outpatient) recipients who receive insulin through a pump, in July.
- Check your monthly statements and call your doctor’s billing office if you have questions.
- If your doctor can’t help, contact Medicare at 1-800-633-4227 or 1-877-486-2048 (TTY), or the Arizona State Health Insurance Assistance Program (SHIP) at 1-800-432-4040.
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Since day one, our goal here at The Copper Courier has always been to empower people across the state with fact-based news and information. We believe that when people are armed with knowledge about what's happening in their local, state, and federal governments—including who is working on their behalf and who is actively trying to block efforts aimed at improving the daily lives of Arizona families—they will be inspired to become civically engaged.
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