Life-saving insulin is cheaper for tens of thousands of Virginians thanks to Biden-Harris price cap

Virginia seniors are saving money on prescription costs thanks to Biden-Harris price slashes.

Margaret Pierce really wanted to retire. She was 65 in 2022 and had been working continuously since her teens, most recently for 11 years as an administrative assistant in Springfield, Virginia. 

There was just one big problem. Pierce has type 1 diabetes, and would have had to spend $400 a month under Medicare for the two types of insulin she needs.

“I was just in shock,” she says. “No way could I afford that.”

In 2023, however, Pierce got a nicer sort of surprise. The Biden-Harris Administration’s Inflation Reduction Act was capping insulin prices for seniors at $35 a month. Pierce promptly handed in her resignation.

“This was so huge for me,” she says. “I was like, wow, the Democrats are OK!” 

In Virginia, as throughout the United States, the soaring price of insulin has forced people with diabetes to make painful choices. Some have been forced to prioritize food or rent over health care. It’s all due to a shameful systemic problem: Americans pay 2.56 times more for prescription drugs than those in 32 other countries.

The Biden-Harris Admin is slashing prescription drug costs

In 2023, however, the Biden-Harris Administration began to ease the pressure. Dramatic new price cuts today are helping tens of thousands of Virginia Medicare beneficiaries who depend on insulin and other prescription medications to treat their diabetes. 

• Medicare recipients – including the 74,000 Virginia seniors who used insulin in 2020 – now need pay no more than $35 a month for insulin, down from a nationwide average of $54. 
• As of 2023, out-of-pocket costs for vaccines, such as shingles, under Part D, have been eliminated, helping scores of thousands of state Medicare beneficiaries.
• Also, beginning in 2025 and for the first time, the nearly 1 million Virginians with Medicare Part D will have the relief of knowing their out-of-pocket costs for all medications are capped. No senior will pay more than $2,000 per year for these life-saving drugs.

These changes are just the start of cost-saving reforms 

• Beginning in 2026, the Democrats’ IRA 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, assuming Democrats remain in charge, Medicare plans to tackle prices for up to 60 other drugs, with 20 more every year thereafter.

For now, the relief affects only older Americans. But Democrats want to extend it to all ages, so that 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 and for Part B (outpatient) recipients who receive insulin through a pump, in July.
• 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-MEDICARE.

And remember:

• The Affordable Care Act protects and expands access to quality health insurance to those who can’t get it through their jobs.  In Virginia, the greatest beneficiaries include 53,000 small business owners and self-employed adults, according to the US Treasury.