About 11% of Nevada’s population – an estimated 254,570 people – have been diagnosed with diabetes, according to the American Diabetes Association. The average annual out-of-pocket costs for people relying on Medicare is $490. (Getty Images)
An estimated 22,000 Nevadans relying on Medicare are expected to have their copays for insulin capped at $35 per month with the passage of Inflation Reduction Act, according estimates by health care groups.
While the tax, climate and health legislation, which President Joe Biden is expected to sign into law Tuesday, included long-sought after reforms on prescription drug pricing, Democratic lawmakers sought to do more to reign in the high costs of insulin.
A provision that would have limited insulin costs for private insurance at $35 per month was stripped out of the bill in the Senate after failing to get enough Republican votes to leave it in.
The package as a whole faced Republican opposition and only passed the Senate in early August through a maneuver called reconciliation, which allowed it to bypass a GOP-led filibuster. The bill passed the House 220-207 Friday.
“By passing this legislation, President Biden and Democrats delivered on their promise to lower health care costs and rein in high drug prices — a stark contrast from every Republican who voted no,” said Leslie Dach, the chair of the health advocacy group Protect Our Care. “American families have been asking and waiting for this day, and now help is on the way.”
The legislation, which includes historic investments to fight climate change, also includes numerous health care components, including capping out-of-pocket expenses for Medicare prescription drugs at $2,000 annually beginning in 2025 and allowing the federal government to negotiate some of the more expensive prescription drugs starting in 2026.
Dach called the legislation “a long-awaited victory for all Americans” that will bring “peace of mind for the millions of people who struggle to make ends meet.”
“Being sick can take over your life and being unable to pay for care devastates families,” she said. “Too many Americans die before their time because they can’t afford health care, and the inequities are even more profound for people of color, rural residents, and people with disabilities.”
For years, health care advocates have noted the high cost of insulin, often through stories of people being forced to choose between paying for the life saving medication and other necessities such as food and rent.
About 11% of Nevada’s population – an estimated 254,570 people – have been diagnosed with diabetes, according to the American Diabetes Association.
A spokesperson for the Nevada Department of Health and Human Services said the agency does not have data on the number of Nevadans relying on private insurance to pay for insulin.
According to a recent report from Kaiser Family Foundation, a nonprofit organization focusing on health care policy, about 1 out of 5 insulin users nationwide with private insurance coverage provided by larger employers pay more than $35 a month.
In a July analysis, the organization estimated 22,235 insulin users in Nevada are on Medicare. There are 13,550 Medicare insulin users without low-income subsidies, the analysis found.
The average annual out-of-pocket costs for people relying on Medicare is $490.
Stand-alone legislation to cap the price on insulin for private insurance and Medicare passed the House 232-193 in late March with 12 Republicans voting with Democrats.
Nevada’s only Republican in Congress, Rep. Mark Amodei, voted against the bill.
Democratic Majority Leader Chuck Schumer said he planned to bring a bill on insulin costs up for a vote in September. It won’t be able to overcome a Republican filibuster unless it receives 60 votes.
Expanded health care subsidies through the Affordable Care Act were expected to expire this year, but the Inflation Reduction Act extended those subsidies through 2025.
Protect Our Care estimates 91,322 Nevadans will “save on monthly health insurance premiums.”
The American Rescue Plan Act passed by Democrats and without any Republican votes last year made it so Nevadans making more than 400% of the federal poverty level who were previously left to pay for insurance on their own eligible for plans.
Officials noted the expansion resulted in a 25% increase in enrollment this year.
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