Lawmakers advance proposal to cap insulin costs at $35 per month

Yahoo

22-05-2025

Nevada could become the 27th state to cap the out-of-pocket cost of insulin for people on private insurance plans. (Photo Illustration by)
Tens of thousands of Nevadans could pay less each month for insulin if lawmakers approve a proposed out-of-pocket cap on commercial insurance plans, according to the state Division of Insurance.
Assembly Bill 555, sponsored by Speaker Steve Yeager, would prohibit private insurance companies from charging people more than $35 for a 30-day supply of a prescription insulin drug. The Senate and Assembly committees on commerce and labor in a joint meeting heard the bill Wednesday and immediately advanced it.
Currently, no such cap on out-of-pocket insulin costs exists for private insurance companies, resulting in 'outrageous and unpredictable' prices for many Nevadans, according to Yeager. The Las Vegas Democrat told the committee he has heard of people paying up to $500 per month for insulin.
Adam Plain from the Nevada Division of Insurance estimated there could be 70,000 Nevadans who have diabetes and are on private insurance plans regulated by the state. Private insurance makes up 18.6% of health care plans in the state, he said. Just under 11% of the adult population in the state has diagnosed diabetes, according to the American Diabetes Association.
More broadly, the association estimated that nearly 270,000 people in Nevada have been diagnosed diabetic and an additional 70,000 have it but haven't been diagnosed.
Twenty-six states, as well as the District of Columbia, have capped out-of-pocket insulin costs for commercial insurance plans, according to the association. Caps range from $25 in Connecticut to $100 bucks in Alabama and Delaware for a 30-day supply.
With AB 555, Nevada policy would align with President Joe Biden's Inflation Reduction Act, which established a $35 out-of-pocket insulin cost cap for people on Medicare.
Yeager referenced research finding that the number of fulfilled insulin prescriptions rose after the cap provision went into effect, suggesting that fewer people are skipping or rationing their medications because of their high costs.
Yeager called his legislation a 'partial answer' and acknowledged it would not help uninsured cash payers. The legislation also does not affect health care plans offered by public employers.
During the hearing, Republican state Sen. John Ellison of Elko commented that President Donald Trump recently said he would lower the cost of all prescriptions.
'I thought that was so amazing,' Ellison added.
Trump signed an executive order on May 12 aimed at lowering drug prices by pressuring pharmaceutical companies to align their U.S. pricing models with those in similarly wealthy countries. It has been panned by Democrats as unserious.
Yeager did not comment on the executive order but said he generally 'would be all for' any federal action that goes beyond what he is proposing at the state level. At the same time, 'there is no reason' Nevada shouldn't do what it can while it can, he argued.
AB 555 will provide financial relief to Nevadans feeling the effects of 'disastrous economic policies at the national level,' he'd said at an earlier point in the hearing, an obvious dig at Trump. 'It is incumbent on us at the state level to find solutions for them.'
Groups supporting AB 555 include the Nevada State Medical Association, Nevada Women's Lobby, Retail Association of Nevada, and Battle Born Progress.
The bill's only public opposition came from Americans for Prosperity, which believes the bill would interfere with 'the natural price mechanisms of the market' and comes with the risk of 'creating a cascade of unintended consequences.'
The Nevada Association of Health Plans has taken a neutral position on the bill, but lobbyist Shelly Capurro said some of its 11 members had concerns about unintended consequences.
After the hearing, during the meeting's general public comment period, Plain, the insurance regulation liaison for the state, addressed lawmakers as a private individual with diabetes. He thanked them for taking on the subject.
He said that with the 'pretty good insurance' he gets as a state employee he pays $320 for a 90-day supply of insulin and three other medications, pen needles, and glucose monitoring.
'The list price for those four meds is $4,000 for a 90-day supply,' he added.
Another Nevadan, Lisa Lynn Chapman, testified that when she first started taking insulin for her Type-2 diabetes, her needles and insulin were free. Then, her employer changed insurance and 'suddenly, my two different insulins cost $60 each, and my needles were $35 a month.'
The cost, she added, was difficult to absorb.
High costs are not what the three men who discovered and secured the patent rights for insulin wanted, Yeager told the joint committee in his closing. One of them, Frederick Banting, is famously quoted as saying, 'Insulin does not belong to me. It belongs to the world.'
They sold their patents for $1 each to the University of Toronto in 1923.
'Somehow we are here in the year 2025 and people are paying $500 a month for something that was assigned patent rights for a dollar over a hundred years ago,' said Yeager. 'To me that is not and never will be acceptable.'