Update for Week Ending June 25, 2022

Update for Week Ending June 25, 2022

Bill to Reduce Insulin Costs Revealed in the Senate

Last week U.S. Senators Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine) – Co-Chairs of the Senate Diabetes Caucus – announced their new bipartisan legislation, the Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act, to lower the skyrocketing costs of insulin. The new, bipartisan legislation builds on Shaheen’s and Collins’ previous efforts to reduce insulin costs by increasing measures to encourage insulin manufacturers to reduce list prices, while extending patient protections that will foster competition and broader access to desperately needed insulin products.

It is estimated that one in every three seniors lives with diabetes. The disease is one of the leading causes of death in the United States, claiming over 100,000 lives in 2021, and is also the most expensive chronic condition in the nation, costing a total of $327 billion per year. The rising cost of insulin presents a barrier to care for a growing number of Americans living with diabetes. Out-of-pocket costs increase with list prices, and for people without insurance, the costs are untenable. According to the Kaiser Family Foundation, Part D enrollees spent nearly $1 billion out-of-pocket on insulin in 2019, four times the amount spent in 2007.

The bill would place a $35 monthly cap on the cost of insulin for patients with private insurance as well as those enrolled in Medicare, though it would not afford the same protections to the uninsured. The bill also seeks to make insulin more accessible by cracking down on previous authorization requirements that can force patients to jump through hurdles to get insurers to help pay for medications.

The legislation further aims to reduce the overall price of insulin, not just how much patients pay for it. The senators are targeting discounts that drug companies provide to insurers and middlemen that have been accused of driving up the costs of drugs at the point of sale.

Senate Majority Leader Chuck Schumer (D-N.Y.) said he’ll bring the bipartisan measure capping the out-of-pocket cost of insulin at $35 per month to the Senate floor soon for a vote.

So far, the only Republican to announce support is Collins, well short of the 10 GOP votes that Democrats will need to avert a filibuster and pass the measure using the normal legislative process.

Majority Leader Schumer and Sen. Joe Manchin (D-W.Va.) are also discussing capping insulin costs in a partisan budget bill that would require just 50 Democrats to pass the Senate. That bill would block insurers and pharmaceutical benefit managers from collecting rebates on insulin products kept at their 2021 Medicare Part D net prices—effectively allowing drug makers to keep a larger share of revenue.

If you live in a state with at least one Republican Senator, TSCL urges you to contact them and urge them to support the Collins-Shaheen Insulin bill.

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Other Bills to Lower Prescription Drug Costs Waiting for Senate Action

As a reminder, the House of Representatives has already passed two pieces of legislation that would lower prescription drug costs.

The first bill is the Elijah Cummings Lower Drug Costs Now Act (H.R.3), which would save Medicare some $450 billion over ten years, mainly by allowing the program to negotiate prices directly with Big Pharma.

The second bill is the Build Back Better Act, a very large bill with many provisions, one of which would enable Medicare to negotiate the prices of up to 10 drugs per year starting in 2023, with that number eventually rising to up to 20 drugs per year. The Congressional Budget Office estimates federal budget savings from the drug pricing provisions would be $297 billion over ten years.

However, the Senate has yet to act on either of these bills because there are not enough votes to pass them.

The positive news is that Sen. Joe Manchin and Majority Leader Schumer have met to discuss a so-far elusive budget reconciliation bill that the pivotal West Virginia Democrat says must address high inflation with deficit reduction, energy production and lower drug prices.

Schumer told reporters Wednesday there are several issues still to work out with Manchin, whose support the Democrats need to get the 50 votes necessary in the evenly divided Senate.

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Drug Company Studies Biased Toward High-Priced Medicines

A new report in the British Medical Journal has found that studies paid for by drug companies are more likely to conclude that a medicine’s benefits outweigh its costs than are independent analyses. By one measure, industry-sponsored studies were twice as likely to conclude that a drug was cost effective.

The finding, based on a review of nearly 8,200 cost-effectiveness analyses, reinforces long-standing concerns about the biases of drug company-backed research. The study’s authors note that skewed studies can affect coverage decisions that might lead to higher drug prices.

This is an important issue because when public and private insurers weigh whether to cover a drug, they often use these so-called cost-effectiveness studies to evaluate whether a treatment’s price tag is offset by overall savings to the health care system.

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TSCL Works With Congressional Office to Pass Social Security Fairness Act

At the request of Congresswoman Abigail Spanberger's (D-Va.) office, TSCL is working to gain more Congressional support for H.R. 82, The Social Security Fairness Act.

TSCL strongly endorses this legislation.

We are contacting TSCL supporters whose Representatives had previously co-sponsored the bill but have yet to do so this year.

The bill corrects two provisions, the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO), that unfairly reduce or even eliminate the Social Security benefits of millions of Americans who have devoted their careers to public service, as well as having worked other jobs that withheld payroll taxes from their wages for Social Security benefits.

The modified benefit formulas used under each of these two provisions reduce the benefit that workers were counting on, but these are benefits that were paid for by Social Security taxes.

To date the bill has 280 co-sponsors including both Democrats and Republicans. Our goal is to get 300 co-sponsors, which would mean there is a good chance the bill can get to the House floor for a vote!

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As we continue moving toward a new normal in dealing with the Covid 19 pandemic, TSCL remains constant in our fight for you to protect your Social Security, Medicare, and Medicaid benefits.

For progress updates or for more information about these and other bills that would strengthen Social Security and Medicare programs, visit our website at www.SeniorsLeague.org or follow TSCL Facebook or on Twitter.