Bill > HR6255

This bill, known as the Affordable Insulin Now Act, establishes new requirements for health insurance plans regarding the cost of insulin products. Starting January 1, 2026, group health plans and health insurance issuers must provide coverage for selected insulin products without applying a deductible and limiting cost-sharing to no more than $35 per 30-day supply or 25 percent of the negotiated product price. "Selected insulin products" means at least one product from each insulin type and dosage form (like rapid-acting, long-acting, vial, or pump), ensuring patients have access to different insulin options. The bill applies to insulin products licensed under specific federal regulations and covers both group and individual health insurance plans. The legislation allows plans to charge higher rates for out-of-network providers and does not require coverage of insulin products beyond the selected types. Cost-sharing payments for insulin will count toward the plan's deductible and out-of-pocket maximum, potentially providing financial relief for people with diabetes who rely on insulin. The bill amends multiple federal laws, including the Public Health Service Act, Internal Revenue Code, and Employee Retirement Income Security Act, to implement these insulin pricing protections.

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https://www.congress.gov/bill/119th-congress/house-bill/6255/all-info