Health Advocates Ask Senate to Include Insulin Copay Cap & Address OOP Costs in Reconciliation Package

By Consumers For Quality Care, on July 29, 2022

Health Advocates Ask Senate to Include Insulin Copay Cap & Address OOP Costs in Reconciliation Package


July 29, 2022


Health Advocates Ask Senate to Include Insulin Copay Cap & Address OOP Costs in Reconciliation Package

In a letter, CQC and 14 consumer and patient-focused organizations express support for package and extending ACA pandemic-era premium subsidies

WASHINGTON – Today, Consumers for Quality Care (CQC) and 14 consumer and patient-focused organizations wrote to members of the Senate advocating for a $35 copay cap on insulin and limits on other out-of-pocket costs to provide relief to more Americans in the reconciliation package.

According to recent research from Impact Research and Public Opinion Strategies on behalf of CQC, the single biggest health care issue facing Americans is out-of-pocket costs. High deductibles, rising out-of-pocket costs, and unpaid medical bills are plaguing American health care consumers – with 80% of voters feeling that these costs only continue to increase each year.

“We ardently support the goal of getting rising health care prices under control for Americans, and we strongly support including the extension of pandemic-era premium subsidies for Americans enrolled in the Affordable Care Act,” the advocates wrote. “However, it is our understanding that as drafted, the provisions of the prescription drug pricing reforms in this bill will not translate into significant or meaningful health care savings for many beneficiaries below the out-of-pocket maximum and will have limited impact on what consumers are actually paying out-of-pocket at the pharmacy counter.”

Affording to KFF, 6 in 10 working-age adults with health insurance coverage have gone into debt getting care in the past five years and debt from health care is nearly twice as common for adults under 30 as for those 65 and older.

Furthermore, medical debt is rampant — exacerbating hardships on people with cancer and other chronic illnesses like diabetes — and millions of people are skipping care because of unpredictable costs.

“Copay caps, which are largely absent from the bill, would lower out-of-pocket costs. We are deeply disappointed that the insulin copay cap was removed from this version of the bill and we urge you to prioritize the inclusion of this and similar copay caps on other drugs as part of the final package. There are more than 37 million Americans living with diabetes, and the $35 insulin cap alone is guaranteed to help each one when they ultimately become a Medicare beneficiary.”

To read the full letter, click here.

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About Consumers for Quality Care

Consumers for Quality Care (CQC) is a coalition of advocates and former policymakers working to provide a voice for patients in the health care debate as they demand better care. CQC is led by a board of directors that includes the Honorable Donna Christensen, physician and former Member of Congress; Jim Manley, former senior advisor to Senators Edward Kennedy and Harry Reid; Jason Resendez, community advocate and health care strategist; and Mary L. Smith, former CEO of Indian Health Service.