Our Ruling: Missing Context
We rate this claim about the Biden administration’s action to be MISSING CONTEXT, based on our research. Some patients who use insulin and EpiPens the fraction who are served by federally qualified health centers may benefit from Trump’s order, but others could suffer if it results in decreased access for the centers to the 340B drug discount program. Also, the freeze through March 22 does not represent final action on the program, so it’s premature to call it a “reversal.”
House Passes Bill To Limit Cost Of Insulin To $35 A Month
The bill stands to benefit millions of Americans with diabetes, but to become law, it will need to attract at least 10 Republican votes in the Senate.
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WASHINGTON A bill to limit the cost of insulin to $35 a month for most Americans who depend on it passed the House on Thursday, raising Democrats hopes that the party could take at least one step toward fulfilling its promise of lowering drug costs.
The bill attracted unanimous support from Democrats who voted, as well as from 12 Republicans, making it a rare piece of bipartisan policy legislation.
To become law, the bill will need to attract at least 10 Republican votes in the Senate to overcome a filibuster. Some lawmakers involved in the effort have expressed optimism that such a coalition might be possible, but few Republican senators have publicly endorsed the bill yet. Senator Susan Collins, Republican of Maine, has been working with Senator Jeanne Shaheen, Democrat of New Hampshire, on a broader bill related to insulin prices.
Other parts of the broader bill would expand health insurance coverage, extending insulin coverage to diabetes patients who are uninsured. The bill that passed the House on Thursday would not improve the affordability of insulin for people who lack health insurance.
Emily Cochrane contributed reporting.
What Is The Federal Register
The Office of the Federal Register publishes regulations in the Federal Register, which is considered the official newspaper of the federal government. Executive orders, such as the one in question, are published in the Federal Register to explain how the president has instructed various executive agencies on how to manage operations and gives the public an opportunity to review and comment on them.
In July 2020, Trump signed a series of executive orders that he proposed as a solution for lowering the high premium prices of prescription drugs, including the price of insulin. Per the Executive Order on Access to Affordable Life-Saving Medications, the Department of Health and Human Services is required to enable Americans without access to affordable insulin and injectable epinephrine through commercial insurance or Federal programs, such as Medicare and Medicaid, to purchase these pharmaceuticals from an FQHC at a price that aligns with the cost at which the FQHC acquired the medication.
HHS finalized the rule in late December but acknowledged the economic impact is expected to be minimal since the vast majority of patients who get insulin from Community Health Centers already get discounted medication. In some cases, those patients receive a one-month supply of insulin for just $7, according to the report published in the Federal Register.
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State Of The Union 2022
During his State of the Union address on March 1, 2022, President Biden specifically called out insulin pricing as a must-do policy change. With his down-to-earth charm, the president welcomed 13-year-old Joshua Davis who lives with T1D, and whod attended the address as a guest of First Lady Dr. Jill Biden. Davis is a young advocate whod previously attended JDRF Childrens Congress, talking with Congress and legislative leaders about diabetes policy change including insulin pricing.
The president is pressing for Congressional action on the Affordable Insulin Now Act, introduced in February 2022 by a group of Democrats including Sen. Michael Bennet and Sen. Raphael Warnock .
While the legislation aims to help those on Medicare plans as well as insurance plans through their employer, it does not address those using insulin who do not have insurance. That remains unaddressed, even as census and other data show that about 10 percent of people in the United States do not have health insurance.
Roughly 54.4 percent of insured Americans have employer-based plans, and more than half of those individuals are subject to high deductibles that often mean theyre forced to pay outrageous list prices for at least part of the year. This means a federal insulin copay cap particularly one that apples to people with the common ERISA-regulated health plans would have the most impact across the board, even if it doesnt achieve the #insulin4all dream of helping everyone who needs it.
House Passes Bill To Limit Cost Of Insulin To $35 Per Month
The Affordable Insulin Now Act was approved 232-193 on Thursday, with 12 Republicans joining Democrats in voting for the bill, ABC News reported.
The bill now moves to the Senate, where it would need some Republican support to pass.
If the bill is signed into law, about 1 in 5 Americans who have large employer coverage and are taking insulin would save money, the Kaiser Family Foundation says. The cost of insulin for patients with insurance ranges from $334 to $1,000 a month, ABC News said, citing the Kaiser Family Foundation.
Republicans in the House and Senate have generally opposed the insulin bill because it could raise insurance premiums for consumers and costs for insurers, ABC News said.
The New York Times reported that the bill would help consumers but would not reduce the amounts paid to companies that make insulin. Insurance companies would have to pay a larger part of the cost, the Times said.
The insulin bill was originally part of President Joe Bidenâs “Build Back Better” agenda that sought to reduce prices for many prescription drugs. When Build Back Better stalled in the Senate, supporters made a standalone bill to address the costs of insulin.
The Times said pharmaceutical companies opposed the price limits in Build Back Better but have not been as vocal in opposing the insulin bill.
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Big Pharma Hated Trump
Trumps most favored nation law seeks to lower prices in Medicare by linking the costs of certain medicines to cheaper prices in other developed countries. People often complain of buying the same drug in the U.S., when the price in Canada and Mexico are far cheaper. Obviously, the pharmaceutical industry strongly opposed the measure, arguing it would bring foreign price controls to the U.S. healthcare system and limit access. Groups including the Association of Community Cancer Centers and the Pharmaceutical Research and Manufacturers of America sued to block the rule. In December 2020, U.S. District Judge Catherine Blake issued a nationwide injunction on Trumps most favored nation drug pricing rule that would tie Medicare Part B drug prices to those paid in other wealthy countries starting January 1, 2021. The Trump administration also removed the gag clauses that prevented pharmacists from telling patients how to buy less expensive drugs. Apparently, pharmacists could not talk to patients about how to buy drugs.
This initiative could save the over 1.3 million seniors who rely on Medicare Part D plans and use insulin, an average of $446, or 66 percent, a year on their insulin costs. For those whose health, and even lives, depend on insulin, the savings will be nothing short of a godsend.
President Bidens Plan For Insulin Prices
This latest plan follows an earlier policy attempt within Bidens failed Build Back Better plan, which all but died in 2021 after opposition stalled the efforts.
In Bidens 2021 BBB policy announcement, the president echoed what the Diabetes Community has been saying for years: Healthcare should be a right, not a privilege.
Insulin prices were highlighted in the White House fact sheet on Bidens plan, with an independent policy analysis cited on how insulin prices could fall by hundreds of dollars on average.
Pharmaceutical companies do groundbreaking, lifesaving work, but there is a difference between developing clinical breakthroughs and driving up prices for the drugs Americans rely on. Change is sorely needed, the White House said in a statement about Bidens plan in 2021.
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Rule Implementation Was Delayed
Biden’s White House chief of staff, Ronald Klain, announced a regulatory freeze of any new and pending rules as Biden took office on Jan. 20. The freeze on the insulin and epinephrine rule is effective until March 22.
According to Bloomberg Law, “A regulatory pause is a common tradition among incoming presidents to ensure that the unfinished policies from the prior administration align with the new one.”
The National Association of Community Health Centers, among others, expressed support for the new administration’s move, saying the Trump rule would not have lowered the cost of insulin and EpiPens for most Americans who use them, as advertised.
In a Jan. 25 statement, it also said the Trump rule reflected “a fundamental misunderstanding” of federally qualified health centers and the 340B drug program, placing extensive administrative burdens on them.
The stated aim was to cut drug prices. However, it triggered alarm among safety net providers and bipartisan lawmakers because it would accomplish the opposite of what the Trump Administration intended ultimately making it harder for health centers to provide affordable life-saving services and prescription drugs especially during the pandemic, the association said.
It pointed out that the only patients affected would be those using the health centers.
Seems Like A Scam: Americans With Diabetes Criticize Bidens Insulin Proposal
Insurance cap includes loopholes and doesnt impact individuals who dont have health coverage in the US
Samia Chowdhury of Ontario, California, saw her work hours in the restaurant industry dwindle from full-time to less than 10 hours a week when Covid shutdowns began in the US in March 2020.
But the loss of work was not her only problem. As a someone who has had type 1 diabetes since she was 12, Chowdhury could not afford health insurance after losing most of her work hours and couldnt get on Medicaid through California. Instead, she relied on visiting medical clinics for insulin prescription refills when she could afford to do so and mutual aid from other people with diabetes around the US.
I could barely scrape together the $35 for the visit, said Chowdhury. I could not make ends meet. I was essentially choosing either a roof over my head or my health insurance.
She relied on the clinics for doctor visits, lab work, and had to ration insulin and supplies while struggling to make ends meet with rent and other bills.
Because I have to take the quick-acting insulin more often when I eat, that would be the only prescription I would pick up. The only way I can describe the effects on someones body is it feels like your whole body is acidic, but at least youre getting to tomorrow, she added. I was making a vial last for up to two months.
Its the most expensive chronic disease in the US.
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Keep Reading For More Details
On January 20, 2021, the Biden administration announced a Regulatory Freeze Pending Review which states that any rules published in the Federal Register that had not yet taken effect would be postponed for 60 days to give the new administration an opportunity to review.
It is important to note that although Trumps Executive Order was published in the Federal Register on December 23, 2020, it had not yet been put into law. The order was not scheduled to go into effect until
Pharma: Biden Freezes Trumps Lower Cost Insulin And Epinephrine Rule
Posted on 01/22/2021
Big pharma is smiling big right now. The big three insulin producers are Eli Lilly and Company, Novo Nordisk A/S, and Sanofi S.A., in which they dominate more than 90% of the world insulin market by value. After swearing-in, U.S. President Joe Bidens HHS froze the Trump administrations December 2020 drug policy that mandates community health centers to pass on all their insulin and epinephrine discount savings to patients.
The rule was finalized in late December 2020. The drug rule was put in place to benefit patients who have a hard time paying for expensive insulin and allergy medication. Former President Trump campaigned on lowering the price of important pharmaceutical drugs like insulin, which is used to treat diabetes, and epinephrine. Diabetes afflicts over a quarter of Medicare beneficiaries and drives billions in Medicare spending every year. More than 20 million Americans have diabetes, in which the body fails to properly use sugar from food due to insufficient insulin, a hormone produced in the pancreas.
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Did President Biden Raise The Cost Of Insulin
President Joe Biden required that all federal rules pending review that were submitted under the previous administration be frozen for 60 days. Among them was one aimed at reducing the cost of insulin and EpiPens. It is important to note that the freeze is temporary until at least March 22, 2021. Headlines run by news publications made the freeze appear to be a more permanent change, which remains to be determined.
In summary, the 60-day regulatory freeze is not causing the price of insulin to increase at Community Health Centers, and there is no evidence to suggest Trumps Executive Order would further lower insulin costs at those facilities, which already offer deep discounts on medication. Additionally, this temporary freeze will not affect the Medicare insulin discount that went into effect on January 1, 2021. To learn more about the temporary freeze, read the following details.
Biden Calls Tor Cap Insulin Costs At State Of The Unionbut This Wont Lower Diabetic Patients Costs Anytime Soon
The news: At his 2022 State of the Union address, President Joe Biden included healthcare agenda items such as capping out-of-pocket costs for insulin at $35 a month.
- For context, a stalled piece of legislation would cap insulin costs, but only for Medicare patients.
Why this matters for the Biden admin:Capping the cost of insulin would help prevent drug prices from continuously rising, a factor that is driving poor medication adherence and contributing to massive healthcare costs for the US.
Nearly 30% of US residents say their prescription drug out-of-pocket costs have increased over the past year, per a 2021 GoodRx survey of over 1,000 US adults.
- Skyrocketing prices have led many adults to delay their refills after running out of their prescription.
- Some have stopped taking medication altogether due to high costs.
Delaying med refills or skipping prescriptions worsens chronic conditions, which could magnify the billions of dollars the US spends on treating it.
- About 90% of the US $3.8 trillion in annual health expenditures is spent on people with chronic illnesses, per the CDC.
Trendspotting: Health consumers are turning to drug discount entrants like GoodRx and to avoid paying for marked up prescriptions.
Drug discount platforms often provide members with lower prices than their insurance out-of-pocket costs:
GoodRx isnt the only platform providing low drug prices, though:
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The Claim: President Joe Biden Is ‘reversing’ An Executive Order Put Into Place By Donald Trump To Reduce Patient Costs For Insulin And Epinephrine
For years, members of Congress have pressured drug companies and pharmacy benefit managers to bring under control the rising costs of insulin and epinephrine for millions of Americans with diabetes or allergies.
In July 2020, President Donald Trump signed four executive orders aimed at reining in prescription drug costs. One required that federally qualified health centers, which purchase insulin and epinephrine through what’s called the 340B drug program, pass along any savings they receive from discounted drug prices to medically underserved patients.
The rule blocks health centers from receiving future federal grants unless they charge patients no more than their acquisition price for insulin and EpiPens epinephrine auto-injectors plus a small administration fee.
At the time, the U.S. Department of Health and Human Services said the move would increase access to insulin and EpiPens for the 28 million patients who visit community health centers annually, over 6 million of whom are uninsured.
On the campaign trail last year, Trump made repeated claims that, because of the executive orders, he was succeeding in his promise to lower drug prices.
HHS approved the rule affecting community health centers in December, and it was to go into effect Jan. 22.
A user on Facebook claims President Joe Biden is now “reversing” Trump’s executive order. This is NOT a partisan issue and will harm Americans, reads the Jan. 22 post, which has almost 1,000 shares.
For Nearly 30 Years Presidents Have Tried And Failed To Curb The Price Of Medicines Despite Strong Public Support For The Idea
Sitting in the Oval Office in August,President Biden listened intently as a diabetic patient told him the price of lifesaving insulin had shot upfrom $39 a bottle in 2001 to $280 today the same exact bottle of insulin, with the same exact formula, the patient Gail deVore said.
Biden had long argued for giving the government a stronger hand in curbing drug prices, and he responded that dayby vowing to tackle insulins cost as part of a social spending bill before Congress. The only thing that Medicare is not allowed to negotiate for a price for is a prescription drug, the president said, and its long past time we changed that.
But the bill Democrats call their Build Back Better Act wont change how Medicare pays for drugs, at least under the framework Biden unveiled Thursday. The omission of drug-price negotiations blindsided liberal Democrats who are the White Houses allies and infuriated advocates, many of whom argue thisis the partys best opportunity to lower pharmaceutical costs for the foreseeable future.
Is this hard? Hell yes, said David Mitchell, a cancer patient and the founder of Patients for Affordable Drugs Now, which has tracked at least $26.5 million in spending by pharma lobbyists to influencethis social spending bill. Were not giving up. Were going to fight until the last possible minute.
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