Insulin Price Cap Doesn't Apply to All Iowans Who Need It

Some 37.3 million Americans, or about one in 10 people, have diabetes. About one in five don’t know they have it, according to the Centers for Disease Control and Prevention. (Adobe Stock)

Drug-maker Sanofi has joined two other large manufacturers in capping monthly insulin prices at $35. In Iowa, advocates for more affordable health care say it’s encouraging news, but they want state lawmakers to mandate the price limit for everyone who needs insulin.

Three major manufacturers are capping insulin prices for people with private insurance, and for Medicare “Part D” recipients. For people who don’t have either, and are on plans regulated by the state, insulin prices can vary dramatically.

AARP Iowa State Director Brad Anderson said that uncertainty leaves a lot of Iowans vulnerable.

“Here in Iowa at the state level,” said Anderson, “there are still around a quarter of a million Iowans on health insurance plans that are regulated by the state, where their insulin is not capped at $35 per month.”

Anderson said the new drug-company price caps are a step in the right direction, but he points out that the companies could decide to change or lift the caps at any time. He said only a state law would end the uncertainty.

Anderson said there is still some question over whose insulin costs are capped and whose are not, which only adds to the confusion.

AARP Iowa is pushing for price-cap uniformity for anyone who needs the drug.

“We we want to pass a law at the state level,” said Anderson, “saying that regardless of whether you’re on Medicare or if you’re on a plan regulated by the state health insurance commissioner, your insulin is capped at $35 a month.”

AARP says insulin costs have risen 600% over the past 20 years, and 14% of Americans who use insulin say it consumes at least 40% of their available income.

Insulin price caps are part of AARP’s Iowa’s legislative agenda, but a bill has not yet been introduced.