# Making Insulin Affordable for All Children Act

This bill caps what young people have to pay out of their own pockets for insulin. Starting in 2024, anyone 26 years old or younger with private health insurance or Medicaid would pay no more than $35 per month for insulin, or 25 percent of what the insurance company negotiated as the price—whichever is lower. The bill also eliminates deductibles for insulin, meaning young people wouldn't have to meet a deductible before their insurance starts helping pay for it.

The bill applies to most common types of insulin used by people with diabetes, including rapid-acting, long-acting, and other varieties available in different forms like vials, pumps, and inhalers. Insurance companies would need to cover at least one version of each type when available. The money young people pay toward insulin would count toward their annual out-of-pocket maximum, just like other medical expenses. However, if someone uses an out-of-network provider, insurance companies could charge them more, and the bill doesn't require coverage of insulin types that aren't on the plan's preferred list.

The practical impact is straightforward: young adults and teenagers with diabetes would have much more predictable and affordable access to insulin. For someone whose insulin might normally cost $200 to $300 per month, capping costs at $35 could mean the difference between affording their medication and rationing doses. This matters because skipping or reducing insulin doses can lead to serious health complications. The bill covers people on employer-sponsored insurance, individual insurance plans, and Medicaid, so it reaches a broad population of young people who depend on insulin to manage their diabetes.

Making Insulin Affordable for All Children Act

Landsman, Greg

Making Insulin Affordable for All Children Act This bill limits cost-sharing for insulin under private health insurance and Medicaid for individuals who are 26 years of age or younger. Specifically, the bill caps cost-sharing under private health insurance and Medicaid for these individuals for a month's supply of selected insulin products at $35 or 25% of a plan's negotiated price (after any price concessions), whichever is less, beginning in 2024.