# Plain Language Summary: Affordable Insulin Now Act of 2023

This bill aims to make insulin more affordable for people who need it by capping how much they have to pay out of their own pockets. Specifically, it would limit what patients have to pay for insulin to $35 per month, no matter which type of insulin they use or how much they need. This is a significant change because insulin prices have skyrocketed over the past decade, with some people paying hundreds of dollars per month for the medication they need to survive.

The bill would apply to most health insurance plans, including those offered through employers and purchased on the individual market. It would also extend to Medicare beneficiaries, meaning seniors and some disabled people would get the same $35 monthly cap on insulin costs. The idea is that by putting a hard limit on what patients pay directly, people with diabetes won't have to choose between buying insulin and paying for other necessities like food or rent. Insurance companies and pharmaceutical manufacturers would absorb the costs above the $35 cap, which supporters argue will create pressure to lower the actual prices of insulin rather than just shifting costs around.

For people without insurance or those who buy insulin out of pocket, this bill wouldn't directly help them since it focuses on insurance coverage. However, supporters argue that capping what insured patients pay could eventually lead to lower overall insulin prices in the market. The bill represents an attempt to address a real problem: many Americans with diabetes have reported rationing their insulin or skipping doses because they can't afford it, which can lead to serious health complications or even death.

Affordable Insulin Now Act of 2023

Warnock, Raphael G.

Affordable Insulin Now Act of 2023 This bill limits cost-sharing for insulin under private health insurance and establishes a program to provide insulin to individuals without insurance. Specifically, the bill caps cost-sharing under private health insurance 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. Further, the Department of Health and Human Services (HHS) must enter into agreements with pharmacies or health care providers to provide insulin to individuals without insurance. HHS must pay such pharmacies or providers an amount equal to the difference between the out-of-pocket cost to the individual for a 30-day supply of such insulin products and $35.