H.R. 10227, Insulin Price Cap and Access Expansion. Quorum's AI analysis reads it as a net benefit — and names who gains.
H.R. 10227 · Net good
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.
The analysis names Insured patients (reduced copays) — and 2 more groups — among the beneficiaries.
The trade-off
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.
Transparency scores 82%, with a medium warning level and no provisions unrelated to the bill's subject.
Who is behind it
Filed by Diana DeGette. Cosponsored by Angie Craig, Chris Pappas, Emanuel Cleaver and Gabriel (Gabe) Vasquez.
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