INSULIN Act of 2026

What Would Change

Currently, many people with commercial health insurance face high out-of-pocket costs for insulin, including deductibles and varying co-pays, and may need prior authorization. Uninsured individuals often struggle to afford insulin, relying on limited assistance programs or paying full price. Pharmacy benefit managers (PBMs) may keep a portion of the rebates they receive from insulin manufacturers. The approval process for generic and biosimilar insulin can sometimes be delayed by certain legal challenges. If this bill becomes law, individuals with commercial health insurance would have their out-of-pocket costs for selected insulin products capped at $35 per 30-day supply (or 25% of the negotiated price, whichever is less, starting in 2028), with no deductible. Prior authorization for these products would generally be prohibited. Pharmacy benefit managers would be required to pass 100% of all insulin-related rebates and discounts directly to group health plans. The FDA would be able to speed up the review and approval of generic and biosimilar insulin products, and the process for challenging drug approvals would be reformed to prevent delays. Additionally, a new 5-year pilot program would provide grants to 10 states to help uninsured individuals get insulin for no more than $35 per month, and a national resource center and hotline would be established to connect uninsured individuals with affordable insulin options and assistance programs.