Biden Accurate on $35 Insulin Cap, Overstates Previous Medicare Costs

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TL/DR –

The cost of insulin for Medicare beneficiaries in the United States has been significantly reduced to an average of $35 per month, according to President Joe Biden. This reduction is due to recent changes by the federal government and drug manufacturers, as well as the Inflation Reduction Act that Biden signed in 2022, which capped out-of-pocket insulin costs at $35 a month for Medicare enrollees. However, Biden’s claim that the cost used to be an average of $400 per month is overstated, with government estimates suggesting the annual cost was around $452 for people with diabetes enrolled in Medicare or private insurance, translating to an average of $37.67 per month.


Insulin Price Drop for Medicare Beneficiaries

In recent years, the cost of insulin in the United States has soared significantly, with Americans paying nearly 10 times more than those in other developed nations. However, recent federal and manufacture-led initiatives have begun to reduce insulin prices, a fact consistently highlighted by President Biden.

In a March 19 campaign event in Reno, Nevada, Biden told attendees that the average cost of insulin had dropped from $400 a month to just $35. This change has been primarily due to the Inflation Reduction Act, which Biden signed in 2022. The regulation capped out-of-pocket insulin costs for Medicare enrollees at $35 a month, with the cap taking effect in 2023.

However, Biden’s claim that the average cost of insulin for Medicare recipients was $400 before the law is misleading. A government estimate found that the average annual out-of-pocket insulin cost for Medicare and privately insured individuals with diabetes was $452, not per month as Biden indicated.

Understanding Insulin Users

Over 37 million Americans have diabetes, and more than 7 million require insulin to manage their blood sugar levels. Approximately 52% of these insulin users are on Medicare. For the majority of these individuals, their out-of-pocket insulin costs were below Biden’s quoted figure of $400 per month.

Medicare Part D, the Medicare prescription drug benefit, outlines different phases of coverage that affect what recipients pay for their prescriptions. As a result, the cost of insulin under Medicare may vary depending on factors like other prescription drugs patients are taking and even the method of insulin administration.

Evaluating Biden’s Statement

The Inflation Reduction Act has undoubtedly helped Medicare enrollees save on insulin costs by capping the monthly price at $35. However, Biden’s claim that beneficiaries were paying an average of $400 monthly for insulin is only partially accurate. While some individuals might have paid that much, depending on their coverage phase and dosage, most did not.

Therefore, Biden’s statement is rated as Half True.


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