Insulin price cuts for 154,000 North Carolina seniors through Biden-Harris initiative

As a result of the Biden-Harris administration’s Inflation Reduction Act, Medicare recipients now pay no more than $35 a month for insulin.

Carrol Olinger was panicking.

It was 2022, and the retired Fayetteville teacher — disabled and between jobs — relied on Medicare to help pay for insulin to treat her type 1 diabetes. But her co-pay for the life-saving drug was more than $200 a month.

“This is not a choice for me: I need insulin to live,” she said. “I admit I did some bad things to save money, like reuse needles.”

Then Olinger heard about the Biden-Harris administration’s $35 price cap on insulin that went into effect in early 2023. 

“It was a huge relief,” she said. “That’s gas money. That’s everyday living money, and my family and I really needed it.”

Biden-Harris administration policies lowered healthcare costs

In North Carolina, as throughout the United States, the soaring price of insulin has forced people with diabetes to make painful choices. Some have had to opt between paying for healthcare and rent. 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 Biden-Harris Administration is working to fix this problem. In a major first step, the 2022 Inflation Reduction Act (IRA) brought dramatic new price cuts that are helping up to 116,000 North Carolina seniors in the state who use insulin.

As a result of the IRA, Medicare recipients now pay no more than $35 a month for insulin—down from a nationwide average of $54. 

Just the start of cost-saving reforms 

That’s not all the Inflation Reduction Act did:

• Beginning in 2025 and for the first time, all 1.7 million North Carolinians with Medicare Part D will have the relief of knowing their out-of-pocket medication costs are capped. No senior will pay more than $2,000 per year for these life-saving medications.

• About 663,000 North Carolinians will save an average of $406 per year on prescription drug costs when the new policies take effect, according to the US Department of Health and Human Services.

• Beginning in 2026, the Democrats’  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 some of the most commonly-used and most expensive drugs in Medicare Part D.

• Over the next four years, Medicare plans to lower 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 no one has to choose between staying healthy and housed and fed.

How the price caps help you

If Medicare is paying for your insulin:

• Your bills should be lower than before. 
• 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:

• Thanks to the Affordable Care Act, the share of North Carolinians without health insurance has fallen by 33% over the past decade. 

• As of 2023, out-of-pocket costs for vaccines, such as shingles, under Part D, have been eliminated, helping tens of thousands of state Medicare beneficiaries.

• While Republicans want to repeal the Inflation Reduction Act — and possibly the Affordable Care Act — Democrats are working to expand access to quality health insurance even more for people who can’t get it through their jobs.  cardin