Grassley claims to support $35 insulin cap he helped kill

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Sen. Chuck Grassley (R-IA) voted against including a price cap for diabetic Americans with private insurance in the Inflation Reduction Act.

Sen. Chuck Grassley (R-IA) told constituents on Wednesday that he backs a $35 cap on the price of a month's supply of insulin. Just 10 days earlier, he voted against that exact same limit.

Grassley was asked by a constituent at a town hall in Corydon, Iowa, about the "hundreds of thousands of Iowans who are struggling to pay [for] their insulin," Iowa Startling Line reported.

"I'm for the $35 cap," Grassley responded. He noted that he also wants more regulation of pharmacy benefit managers, the intermediary companies that coordinate between pharmacies and drug manufacturers.

The constituent then reminded him, "There was a chance to cap that insulin at $35 for everybody in that bill and it didn't pass," referring to the Inflation Reduction Act signed into law on Tuesday by President Joe Biden.

"It would have just capped it for the people that are on commercial health insurance," Grassley answered. "It wouldn't have done anything for the uninsured." He then moved on to another question.

After drastic price increases over the past decade, a month's supply of insulin can cost patients anywhere between $334 and $1,000, according to a 2020 Kaiser Family Foundation analysis. Even people with insurance often pay hundreds of dollars a month and face high deductibles for the life-saving treatment.

The Senate Democratic majority's original draft of the legislation — which also invests hundreds of billions of dollars in energy and climate change, infrastructure, and affordable health care, while allowing the federal government to negotiate lower drug prices for older Americans — included provisions capping the monthly copayment for a month's supply of insulin at $35 for anyone on Medicare or private insurance. The Affordable Insulin Now Act passed in the House in March with 220 Democrats and just 12 Republicans voting for it.

But Senate Republicans raised a parliamentary objection to the cap for Americans with private insurance plans, arguing that because it did not directly affect government spending, it could not be part of a budget reconciliation package and be passed with a simple majority.

After Senate parliamentarian Elizabeth MacDonough sustained the objection and that part was struck from the bill, Democrats attempted to add it back in. Seven Republicans joined all 50 Democrats to vote in favor, but that fell three votes short of the 60-vote threshold the parliamentarian deemed necessary. Grassley and 42 other Republicans voted no.

Grassley, along with every other Republican in Congress, also voted against the final package, which included the $35 insulin cap and an out-of-pocket cap for prescription drug costs for anyone on Medicare.

In an emailed statement, a Grassley spokesperson told the American Independent Foundation:

Sen. Grassley stated in the clip that you sent that he supports a $35 cap that also includes policy to address the underlying cause of rising drug prices by holding PBMs accountable. He supports the bipartisan Shaheen-Collins plan that combines these two provisions. The legislation that was voted on as a part of the recent partisan spending bill does not include any of those critical accountability measures geared at preventing further price increases. The cap only applies to people with private health insurance. Folks with no insurance at all, who are most likely to pay the highest price for insulin, wouldn't benefit from the policy. That's why Sen. Grassley also supported an amendment that would ensure people with high deductibles or no insurance at all could access affordable insulin. That measure only needed 51 votes. It was supported by all 50 Republicans but not a single Democrat voted for it.

While Grassley is technically correct that the $35 cap proposed in the Inflation Reduction Act would not have covered the insured, this is a bit of a red herring.

Roughly 65% of Americans have private health insurance, while just 8.6% of Americans are uninsured, according to an April report from the nonpartisan Congressional Research Service. The uninsured rate reached an all-time low in 2022.

The cap Grassley voted against would have benefited the vast majority of Iowans living with diabetes, while the amendment Grassley backed would have only provided discounted insulin for a fraction of Iowans living with diabetes.

Grassley has received at least $1.4 million in campaign contributions from the pharmaceutical industry since 1989, and he has taken more than $100,000 from political action committees representing private health insurance companies, according to Federal Election Commission records.

Under the Democrats' proposal, private insurers would be on the hook for a larger share of the cost of insulin.

Grassley is seeking his eighth six-year Senate term this November. He will face Democratic nominee Mike Franken, a retired Navy admiral who has advocated for universal health insurance.

Franken's campaign manager lambasted Grassley for his vote against the price cap in an Aug. 7 press release:

Sen. Grassley can talk all he wants about lowering drug prices, but what he actually does in Washington — from writing the bill to ban Medicare from negotiating for lower prices to now voting against capping the cost of insulin at $35 a month – shows that what he actually cares about is protecting the profits of his drug industry donors.

Franken has said he would have backed the Inflation Reduction Act and its affordable insulin provisions.

Published with permission of The American Independent Foundation.