Iowa lawmakers move to cap insulin costs at $75 a month

DES MOINES — Iowa lawmakers are considering a bill to limit out-of-pocket costs for insulin at $75 a month.

Lawmakers advanced the bill out of a Senate subcommittee on Monday, saying they hoped it would increase access to the diabetes drug. Insulin is used to treat high blood sugar in people with both Type 1 and Type 2 diabetes.

The bill would apply to people on state-regulated health insurance plans, including people with private health insurance and state-provided Medicaid. Uninsured Iowans would not be covered by the bill.

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Sen. Carrie Koelker, a Republican from Dyersville who proposed the bill — Senate File 2214 — said it had been in the works for at least six years, and she hopes this can be the year it becomes law.

“It may not be enough, but if it saves one life, it should not be at the expense of the cost of insulin,” she said during the committee meeting. "So I'm happy to sign this out and continue the conversation."

Sen. Sarah Trone Garriott, a Democrat from Waukee, said she supported taking action to cap insulin costs, but she was curious whether the bill would leave out anyone who needed the medication.

“I am interested to learn more about, are there other consumers, other Iowans who might not be positively impacted by this bill?” she said. "Are there folks who are underinsured, not insured?”

Theresa Hildreth, who has Type 1 diabetes, told senators on the subcommittee that insulin is a lifesaving drug for her and other diabetic people.

“What is the one thing in your life you absolutely cannot live without?” she said. “For me, it’s insulin. Without it, I’m a dying woman.”

Iowa House lawmakers passed a bill in 2021 that would have capped insulin costs at $100 a month, but the bill never passed out of the Senate. House Democrats last year proposed a bill that would cap insulin costs at $25.

The cost of insulin varies widely by product and health plan, and prohibitively high costs have spurred government action in recent years. One study found people with diabetes have an average of $12,000 in annual costs associated with the condition.

Several states have caps on insulin copays in place, ranging between $25 and $100 for a 30-day supply. Minnesota and Nebraska each have a cap of $35, while Illinois has a cap of $100.

The Inflation Reduction Act in 2022 capped the out-of-pocket one-month insulin cost for Medicare patients at $35.

As more and more states have regulated the price of insulin, insurers and manufacturers have largely brought prices down across the country. In March, drug manufacturer Eli Lilly capped the cost for patients of its insulin at $35 a month.

Lobbyists for multiple health insurance companies said during the Senate subcommittee meeting they already price their out-of-pocket insulin costs lower than the $75 cap in the bill.

Noah Tabor, a lobbyist for Medica, noted that uninsured and underinsured Iowans would not be covered by the bill.

“As markets moved on insulin, (Medica has) capped the copays on insulin at $25 for a number of years," Tabor said. "…Insulin is certainly a tender topic. I’m not sure of the utility of this bill. Who is going to be helped by this bill?”