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Capping Insulin Costs: Maximum $35 Monthly Copay for Insured Patients starting 2026.

This law establishes a maximum cost-sharing limit for selected insulin products covered by group and individual health plans. Starting in 2026, insured individuals will pay no more than $35 per 30-day supply, and health plans cannot apply deductibles to these specific medications. This change aims to significantly reduce the monthly financial burden of diabetes management for millions of Americans.
Key points
The maximum cost for a 30-day supply of selected insulin will be capped at $35 or 25% of the negotiated price, whichever is lower.
Health plans are prohibited from requiring patients to meet their deductible before covering the cost of selected insulin products.
All cost-sharing payments made for insulin must count toward the patient's annual out-of-pocket maximum.
The rules apply to plan years beginning on or after January 1, 2026.
article Official text account_balance Process page
Introduced
Citizen Poll
No votes cast
Additional Information
Print number: 119_HR_6255
Sponsor: Rep. Craig, Angie [D-MN-2]
Process start date: 2025-11-21
Lustra uses Artificial Intelligence. Verify details in source documents.
Summarized by: gemini-2.5-flash-preview-09-2025
Source data: api.congress.gov
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OFFICIAL LEGAL TITLE

Affordable Insulin Now Act

FREQUENTLY ASKED QUESTIONS

What is the official ID of this bill?

The official print number for this legislation is 119_HR_6255.

Which chamber initiated this legislation?

This legislation was initiated in the House of Representatives.

When did the legislative process begin?

The process officially started on 2025-11-21.

What are the main provisions?

Key points include:

  • The maximum cost for a 30-day supply of selected insulin will be capped at $35 or 25% of the negotiated price, whichever is lower.
  • Health plans are prohibited from requiring patients to meet their deductible before covering the cost of selected insulin products.
  • All cost-sharing payments made for insulin must count toward the patient's annual out-of-pocket maximum.
  • The rules apply to plan years beginning on or after January 1, 2026.
What is the specific legal status?

The current status is Introduced.

Where can I read the full text of this legislation?

The full official text is available at: View full text

Who is the primary sponsor?

The primary sponsor is Rep. Craig, Angie [D-MN-2].

What is the latest detailed status?

The latest detailed status is: Introduced in House

Is this summary verified?

Yes. This content was analyzed by AI and verified by the Lustra Judge System on 2025-12-23.

CATEGORIES

Health