Insulin price cuts for 122,000 Michigan seniors through Biden-Harris initiative

Hundreds of thousands of Michigan seniors, including a Portage manufacturer, are seeing big savings in prescription drug costs, thanks to the Biden-Harris administration.

Dick Hewitt, 73, is tired of seeing his fellow Michigan senior citizens take bus trips to Canada, prescription slips in hand, to buy affordable medications.

That’s why the Portage resident is thrilled about the Biden-Harris price cap on insulin for Medicare members – a special boon for up to 122,000 Michigan Medicare beneficiaries who use insulin to treat their diabetes.

“Affordable health care really ought to be a right,” says Hewitt, a retired robotics manufacturer, master gardener and father of three, who takes insulin for his Type 2 diabetes. “So this is a tremendous step in the right direction.”

The Biden-Harris plan cuts costs

In Michigan, as throughout the United States, the soaring price of life-saving medications – including insulin, which costs only $2-4 a vial to produce – has for years forced seniors to make painful choices. Some have had to choose between paying for health care or rent. Others have skipped taking some medications, even at the risk of getting sick. This is the result of a shameful systemic problem:  Americans pay 2.56 times more for prescription drugs than those in 32 other countries.

The 2022 Inflation Reduction Act from the Biden-Harris administration is finally easing the pressure.

• Medicare recipients now pay no more than $35 a month for insulin—down from a nationwide average of $54. 
• Also, beginning in 2025 and for the first time, all 1.7 million Michiganders with Medicare Part D will know that their out-of-pocket medication costs are capped. No senior will pay more than $2,000 per year for these life-saving medications.
• Currently, Medicare beneficiaries with serious illnesses such as cancer or lung disease are confronted with thousands of dollars in out-of-pocket prescription drug costs. That includes about 37,000 Michigan seniors who would otherwise have out-of-pocket costs above the cap, according to the Kaiser Family Foundation (KFF). 

These changes are just the start of cost-saving reforms: 

• Beginning in 2026, the Biden-Harris Inflation Reduction Act will cap costs for 10 other medications for Medicare recipients. 
• The 10 drugs, which treat illnesses including heart failure, blood clots, arthritis, and Crohn’s disease, represent the highest spending for drugs in Medicare Part D.
• Over the next four years, unless Republicans repeal the Inflation Reduction Act, Medicare plans to lower prices for up to 60 other drugs on total, with 20 more every year thereafter.
• As of 2023, out-of-pocket costs for vaccines, such as shingles, under Medicare Part D, have been eliminated, helping scores of thousands of state Medicare beneficiaries.
• For now, the relief affects only older Americans. But Democrats want to extend it to all ages, so no one has to choose between staying healthy and housed and fed.

How this helps you

If Medicare is paying for your insulin:

• Your bills should already be lower.
• The new cap kicked in for Part D (drugs) recipients in January of 2023 and for Part B (outpatient) recipients who receive insulin through a pump, in July 2023.
• Check your monthly statements and call your doctor’s billing office if you have questions.
• If your doctor can’t help, contact Medicare at 1-800-633-4227 or 1-877-486-2048 (TTY), or the Seniors’ Health Insurance Information Program (SHIIP) at 1-855-408-1212 

And remember:

• The Democrats’ Affordable Care Act guarantees health insurance to nearly 2 million Michigan residents with preexisting conditions, helped almost a million more residents get covered through Medicaid expansion, and allows tens of thousands of young people to keep their parent’s insurance until age 25.