Congress caps insulin copays at $35, funds uninsured access programs
H.R. 10227 — INSULIN Act of 2026 · Filed by Diana DeGette (D-CO) · 4 cosponsors · Introduced Sep 2, 2026 · Referred to committee
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What it does
This bill caps insulin copays at $35 per 30-day supply for insured patients starting in 2028, with the cap potentially lowering to 25% of the negotiated price if that is less. It also funds a resource center and hotline to help uninsured individuals find manufacturer assistance programs, directs a study on uninsured insulin users, and expedites FDA approval of competing biosimilar insulins to increase competition and lower prices.
Why we flagged it
The bill's operative mechanism is a copay cap for insured patients ($35 or 25% of negotiated price) combined with biosimilar competition acceleration and uninsured patient support. The primary civic effect is reducing out-of-pocket insulin costs across both insured and uninsured populations.
What the text implies
- The copay cap applies only to 'selected insulin products' (at least one of each type/dosage/delivery form chosen by the plan), not all insulins—plans retain discretion to impose higher cost-sharing on non-selected products, potentially steering patients toward cheaper options.
- Biosimilar expedited review may accelerate market entry of competing insulins, but the bill does not guarantee price reductions for uninsured patients; it relies on market competition and manufacturer assistance programs, which are voluntary.
The full analysis lists 5 implications of this text.
Who stands to gain
Insured patients (reduced copays); Biosimilar manufacturers (expedited FDA review pathway); Uninsured patients (via manufacturer assistance programs and resource center)