ORLANDO, Fla. – A major element of President Joe Biden’s marquee ‘Build Back Better’ legislation will be addressing rising medical expenses for American families.

The bill aims to allow Medicare to negotiate prescription prices with manufacturers, cap annual out of pocket expenses for seniors, and place limits on some of the pricing structure for insulin.

“You don’t have a choice, you have to buy it or you die,” said Jeff Dunlop.

Jeff has lived with Type 1 diabetes for 36 years. He was diagnosed at the age of 9. His son Jake was diagnosed 3 years ago at the age of 11.

Jeff Dunlop estimates his family spends about $1,200 out of pocket for a 3-month supply of insulin for him and his son. This is the rate based on his employer’s medical insurance.

Under the Build Back Better proposal, copay prices for insulin products could not exceed $35 for Medicare Part D and private group or individual health care plans. 

A single vial of insulin currently costs about $300 for those without insurance, which Jeff Dunlop points out remains a significant issue.

A 2019 congressional study found uninsured Americans pay far more for insulin than others.

The cost of insulin in the U.S. for uninsured Americans is more than 13 times the price than in Canada, 15 times more than in the United Kingdom, and 23 times more expensive in the U.S. for uninsured Americans than in Australia, according to the congressional report.

Dunlop said it’s critical that lawmakers continue to focus on insulin pricing, not just the proposed copay caps, but caps on total pricing.

At least seven states have copay caps in place:

• Colorado: $100 cap for 30 day supply (Enacted January 1, 2020)
• Illinois: $100 cap for 30 day supply (Enacted January 1, 2021)
• Maine: $35 cap for 30 day supply (Enacted January 1, 2021)
• New Mexico: $25 cap for 30 day supply (Enacted January 1, 2021)
• New York: $100 cap for 30 day supply (Enacted January 1, 2021)
• Oklahoma: $30 cap for 30 day supply (Enacted November 8, 2021)
• Utah: $30 cap for 30 day supply (Enacted January 1, 2021)
• Washington: $100 cap for 30 day supply (Enacted January 1, 2021)
• West Virginia: $100 cap for 30 day supply (Enacted July 1, 2021)

Florida State Senator Janet Cruz (D-Hillsborough County) filed Senate Bill 678 for the upcoming 2022 Florida Legislative Session. 

The proposal would mirror other states’ insulin pricing caps.

A 2019 report from Florida’s Diabetes Advisory Council estimated 2.4 million people in the Sunshine State have diabetes, and another 5.8 million Floridians have prediabetes.

“Over the past 20 years, the prevalence of diagnosed diabetes among Florida adults more than doubled, increasing from 5.2 percent in 1995 to 11.8 percent in 2016,” the report states.