Nearly 60,000 Wisconsin Seniors on Medicare Need Insulin. So Why Did Republicans Oppose Biden’s $35-a-Month Insulin Cap?

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By David Hovde

February 15, 2023

An Appleton man who attended President Biden’s address says the ‘state of the union’ depends on the state of working Americans.

Last week, as I sat in the US Capitol and listened to President Joe Biden deliver the State of the Union address, it became clear to me that an essential consideration for the president’s assessment of the state of our country depends on the economic security of working families and seniors like me.

While families and seniors across our country do not have all the tools we need just yet, I feel relieved that because of the work and leadership of the Biden-Harris Administration and Democrats like Senator Tammy Baldwin, we are closer to having what we need to provide for ourselves and our families.

This is due in large part to the Inflation Reduction Act, a historic bill that will deliver tangible, economic relief on prescription drugs, health care, and energy costs. Notably, some of the bill’s provisions have already gone into effect as of January 1, including a $35 cap on insulin costs for Medicare beneficiaries like me.

This is huge. Like so many other folks across the state and country, I rely on insulin to keep me alive and healthy. And for the past 15 years during which I have needed this medication, I’ve also noted with dismay the growing number of those dependent on insulin who have to worry about affording other essential expenses while still maintaining their quality of life.

Though I knew I would feel added financial security enrolling in Medicare, I did not realize the impacts would be this significant. Prior to enrolling in Medicare, I was fortunate to have access to a fairly comprehensive and stable insurance plan through my employer. After I retired, I was still able to access health insurance through that employer, though I started paying a significantly higher share of the monthly premium during those years.

Despite having good coverage, I was still paying hundreds of dollars each month for my insulin medications, and for individuals without healthcare insurance or prescription drug coverage, the situation is much more dire. Insulin costs less than $10 per vial to produce, yet with drug companies rapidly raising the price of this life-saving drug, many have had to make difficult decisions about whether and how to pay for medication and for their other essential expenses. To alleviate economic strains, many people who rely on insulin will “stretch” their medications, for example, trying to make three months’ worth of medication work for four months. And though this may lessen financial pressures in the short-term, a lack of a steady, adequate supply of insulin often leads to the development or worsening of a number of other serious health issues. Ultimately, of course, this adds further economic pressures and, more importantly, has negative impacts on an individual’s health.

The $35 insulin copay cap will have a great impact on Wisconsinites. In 2020, roughly 59,000 Medicare beneficiaries in Wisconsin used insulin. That’s 59,000 people who are beginning to have more equitable access to the life saving and quality-of-life care they need and deserve.

The insulin copay cap is not the only thing already implemented as of last month. Drug manufacturers will also need to pay rebates to Medicare if their price increases for certain drugs exceed inflation. Additionally, all recommended vaccines for adults, such as shingles, will be free to seniors. In 2020, an estimated 106,000 Wisconsin Medicare beneficiaries received a Part D vaccine, and this number is likely to rise as the vaccines become more accessible.

None of these provisions in the Inflation Reduction Act should have been controversial; it’s a historic bill that will make a difference in the lives of millions of Americans. Unfortunately, Republicans in Congress did not see it that way. Not a single Republican from Wisconsin voted to support this new law.

Access to the care and prescriptions we need to stay alive and healthy is not a privilege, it is a right, contributing directly to our overall quality of life. Based on what I heard last week, the Biden Administration and leaders like Senator Baldwin clearly recognize this fact and are committed to continuing the work on behalf of working families and seniors.


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