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Insulin price caps for private markets on life support with condensed Senate schedule
September 12 2022, 08:00

Campaign season, competing legislation, and the unknown of the lame duck session may prevent the Senate from acting on a bill to cap out-of-pocket insulin costs, despite efforts by the lawmakers behind the bill to push it ahead.

"I’m glad Senate Democrats made important progress to address the skyrocketing costs of insulin in the Inflation Reduction Act, but those provisions are only the beginning. To get at the full scope of these surging costs, we need a comprehensive solution," Sen. Jeanne Shaheen, D-N.H., the lead sponsor of the bill, said in a statement Friday. "We saw bipartisan support for the initial insulin provisions in the IRA, and I believe we can build on that progress in the weeks ahead."

Senate Majority Leader Chuck Schumer, D-N.Y., vowed in an MSNBC appearance last month that the Senate will vote on price caps for insulin on private plans. 

But the path is looking increasingly difficult with a packed Senate schedule. And Sen. Susan Collins, R-Maine, the chief GOP sponsor of the legislation, says she blames Schumer for making the bill harder to pass by decoupling price caps for Medicare recipients from similar caps on private plans. 

"I think our path is more difficult because of Sen. Schumer's decision, which was contrary to what he told me, to break off parts of the bill and put it in reconciliation," Collins told reporters Thursday. 

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"Jeanne and I still believe that our bill has a great deal of merit and would rectify the problem that reconciliation does not apply to the commercial market, nor does it address the underlying problem of rebates and high list prices," Collins also said. "The $35 cap for Medicare, it doesn't really address the inherent conflicts of interests in the way that insulin gets to consumers."

Time could be the biggest factor in whether Collins and Shaheen get a vote on their bill. 

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The Senate is already set to vote on multiple judicial confirmations early next week. After that, a bill to protect gay marriage rights at a federal level is likely to come to the floor as early as next week, although Sen. Tammy Baldwin, D-Wis., said she expects it to slip to "the following week."

If the gay marriage bill passes, which its advocates are optimistic about, the next item on the Senate's agenda will be a funding bill to avert a government shutdown. That may be a time-consuming fight with progressives and Republicans alike smarting over Schumer's deal with Sen. Joe Manchin, D-W.Va., to include permitting reform for energy projects in exchange for his vote on the Inflation Reduction Act.

Once that bill is across the finish line, it's possible Schumer will send everyone home to campaign rather than keeping the Senate in session until October. 

That could push any conversation about insulin prices until the lame duck session in November and December, when congressional priorities could be radically different. A senior Democratic aide nevertheless said the insulin bill is something they want to get done, and that they are "discussing the best path forward."

If the Senate does get to the Shaheen-Collins legislation, supporters are optimistic it can pass. Seven Republicans voted to override the Senate's "Byrd Rule" and allow a commercial insulin price cap during the "vote-a-rama" on Democrats' social spending and tax bill. 

In an interview with the Portland Press-Herald last month, Collins pointed to that as evidence she can secure even more votes outside the context of a massive party-line bill.

GOP opponents of the legislation, meanwhile, question why Republicans would be willing to back what they say is little more than big government meddling in the market.

"It’s not political, it’s a fact: the only way to truly lower prices without harming quality is to increase competition in the free market. Any price-setting effort will only push those costs from the product to your premiums," Rep. Kevin Hern, R-Okla., one of the most vocal opponents of the legislation in the House, told Fox News Digital. "Democrats are looking for an easy win before the midterms, they’ll spin it however they want and ignore the true cost to Americans who depend on insulin. Republicans should not be party to a socialist price-setting scheme."