Making Insulin Affordable for All Children Act

Key Points

• This bill would cap out-of-pocket insulin costs for people 26 and younger on private health insurance at $35 per 30-day supply, or 25% of the negotiated price if that amount is lower.
• Insurance plans would be required to cover at least one version of every dosage form and type of insulin, including rapid-acting, long-acting, and premixed varieties, in formats like vials, pumps, and inhalers.
• Deductibles would not apply to these insulin products, meaning young patients could access affordable insulin from the start of their plan year without first meeting a spending threshold.
• Any copay a patient does pay for insulin would still count toward their deductible and out-of-pocket maximum, helping families reach their insurance safety net faster.
• The bill covers employer-sponsored plans, individual market plans, and catastrophic plans. It amends the Public Health Service Act, ERISA, and the Internal Revenue Code to ensure broad coverage across private insurance types, with changes taking effect for plan years starting January 1, 2026.
• Federal agencies could use informal guidance rather than formal rulemaking to implement the law, potentially speeding up the process.

Votes

No votes have been recorded for this legislation yet.