Bill > HR2636

This bill, called the Making Insulin Affordable for All Children Act, aims to make insulin more affordable for individuals 26 years of age or younger by establishing new requirements for private health plans. Starting January 1, 2026, group health plans and health insurance issuers must provide coverage for "selected insulin products," which means at least one insulin product from each dosage form and type (such as rapid-acting, long-acting, etc.). These plans will be prohibited from applying any deductible to insulin products and will be limited to charging no more than $35 per 30-day supply or 25 percent of the negotiated product price, whichever is less. The bill covers insulin products licensed under specific federal regulations and applies to various types of health plans, including individual and group health insurance, employer-sponsored plans, and catastrophic plans. Any cost-sharing payments for insulin will count toward the plan's deductible and out-of-pocket maximum. The legislation does not require coverage of insulin products for individuals over 26 or mandate coverage of insulin products not specifically selected by the health plan. The bill will be implemented through guidance from the Departments of Health and Human Services, Labor, and Treasury.

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https://www.congress.gov/bill/119th-congress/house-bill/2636/all-info