Insulin Access for All Act of 2021
This bill prohibits cost-sharing (e.g., copayments) under Medicaid and the Medicare prescription drug benefit for insulin and associated medical supplies.
[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4158 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 4158
To amend titles XVIII and XIX of the Social Security Act to eliminate
cost sharing with respect to coverage of insulin as a covered part D
drug under the Medicare program or as a covered outpatient drug under
the Medicaid program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 24, 2021
Mr. Rush (for himself, Ms. Adams, Ms. Barragan, Ms. Bass, Mrs. Beatty,
Mr. Bishop of Georgia, Ms. Bonamici, Mr. Brown, Mr. Butterfield, Ms.
Clarke of New York, Mr. Cohen, Mr. Danny K. Davis of Illinois, Mrs.
Demings, Mrs. Dingell, Mr. Evans, Mr. Garcia of Illinois, Ms. Garcia of
Texas, Mr. Grijalva, Mrs. Hayes, Ms. Johnson of Texas, Mr. Johnson of
Georgia, Ms. Kelly of Illinois, Mr. Krishnamoorthi, Ms. Lee of
California, Mr. Meeks, Ms. Meng, Ms. Norton, Mr. Payne, Mr. Raskin, Ms.
Roybal-Allard, Mr. Ruppersberger, Mr. Sablan, Ms. Schakowsky, Ms.
Sewell, Mr. Sires, Mr. Takano, Mr. Thompson of Mississippi, Ms. Tlaib,
and Mr. Veasey) introduced the following bill; which was referred to
the Committee on Energy and Commerce, and in addition to the Committee
on Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend titles XVIII and XIX of the Social Security Act to eliminate
cost sharing with respect to coverage of insulin as a covered part D
drug under the Medicare program or as a covered outpatient drug under
the Medicaid program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Insulin Access for All Act of
2021''.
SEC. 2. ELIMINATING COST SHARING WITH RESPECT TO COVERAGE OF INSULIN AS
A COVERED PART D DRUG UNDER THE MEDICARE PROGRAM OR AS A
COVERED OUTPATIENT DRUG UNDER THE MEDICAID PROGRAM.
(a) Medicare.--
(1) Elimination of cost sharing for insulin and certain
associated medical supplies furnished to part d eligible
individuals.--Section 1860D-2 of the Social Security Act (42
U.S.C. 1395w-102) is amended--
(A) in subsection (b)--
(i) in paragraph (1)(A), by striking ``The
coverage'' and inserting ``Subject to paragraph
(8), the coverage'';
(ii) in paragraph (2)--
(I) in subparagraph (A), by
inserting after ``Subject to
subparagraphs (C) and (D)'' the
following: ``and paragraph (8)'';
(II) in subparagraph (C)(i), by
striking ``paragraph (4)'' and
inserting ``paragraphs (4) and (8)'';
and
(III) in subparagraph (D)(i), by
striking ``paragraph (4)'' and
inserting ``paragraphs (4) and (8)'';
(iii) in paragraph (4)(A)(i), by striking
``The coverage'' and inserting ``Subject to
paragraph (8), the coverage''; and
(iv) by adding at the end the following new
paragraph:
``(8) Elimination of cost sharing for certain covered part
d drugs.--The coverage does not impose any deductible,
copayment, coinsurance, or other cost sharing for insulin (as
described in subparagraph (B) of subsection (e)(1)) or medical
supplies associated with the injection of insulin (as described
in such subparagraph).''; and
(B) in subsection (c), by adding at the end the
following new paragraph:
``(4) Same elimination of cost sharing for certain covered
part d drugs.--The coverage is in accordance with subsection
(b)(8).''.
(2) Elimination of cost sharing for insulin and certain
associated medical supplies furnished to part d eligible
individuals who are subsidy eligible individuals.--Section
1860D-14(a) of the Social Security Act (42 U.S.C. 1395w-114(a))
is amended--
(A) in paragraph (1)--
(i) in subparagraph (D)--
(I) in clause (ii), by striking
``In the case of'' and inserting
``Subject to subparagraph (F), in the
case of''; and
(II) in clause (iii), by striking
``In the case of'' and inserting
``Subject to subparagraph (F), in the
case of''; and
(ii) by adding at the end the following new
subparagraph:
``(F) Elimination of cost sharing for certain
covered part d drugs.--Coverage that is in accordance
with section 1860D-2(b)(8).''; and
(B) in paragraph (2)--
(i) in subparagraph (D), by striking ``The
substitution'' and inserting ``Subject to
subparagraph (F), the substitution'';
(ii) in subparagraph (E), by inserting
after ``Subject to'' the following:
``subparagraph (F) and''; and
(iii) by adding at the end the following
new subparagraph:
``(F) Elimination of cost sharing for certain
covered part d drugs.--Coverage that is in accordance
with section 1860D-2(b)(8).''.
(3) Applicability.--The amendments made by this subsection
shall apply with respect to insulin, and medical supplies
associated with the injection of insulin, furnished on or after
January 1, 2022.
(b) Medicaid.--
(1) In general.--Section 1916 of the Social Security Act
(42 U.S.C. 1396o) is amended--
(A) in subsection (a)(2)--
(i) in subparagraph (H), by striking ``or''
at the end;
(ii) in subparagraph (I), by striking ``;
and'' and inserting ``, or''; and
(iii) by adding at the end the following
new subparagraph:
``(J) insulin furnished as a covered outpatient
drug (as defined in section 1927(k)(2)) and medical
supplies associated with the injection of such insulin;
and''; and
(B) in subsection (b)(2)--
(i) in subparagraph (H), by striking ``or''
at the end;
(ii) in subparagraph (I), by striking ``;
and'' and inserting ``, or''; and
(iii) by adding at the end the following
new subparagraph:
``(J) insulin furnished as a covered outpatient
drug (as defined in section 1927(k)(2)) and medical
supplies associated with the injection of such insulin;
and''.
(2) Alternative cost sharing limitation.--Section
1916A(c)(2) of the Social Security Act (42 U.S.C. 1396o-
1(c)(2)) is amended by adding at the end the following new
subparagraph:
``(D) Nonapplicability of cost sharing to
insulin.--In no case may the cost sharing under
paragraph (1)(A) apply with respect to insulin
furnished as a covered outpatient drug (as defined in
section 1927(k)(2)) and medical supplies associated
with the injection of such insulin.''.
(3) Effective date.--
(A) In general.--Subject to subparagraph (B), the
amendments made by this subsection shall apply with
respect to covered outpatient drugs furnished on or
after January 1, 2022.
(B) Exception for state legislation.--In the case
of a State plan under title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.) that the Secretary of
Health and Human Services determines requires State
legislation in order for the respective plan to meet
any requirement imposed by amendments made by this
subsection, the respective plan shall not be regarded
as failing to comply with the requirements of such
title solely on the basis of its failure to meet such
an additional requirement before the first day of the
first calendar quarter beginning after the close of the
first regular session of the State legislature that
begins after the date of the enactment of this Act. For
purposes of the previous sentence, in the case of a
State that has a 2-year legislative session, each year
of the session shall be considered to be a separate
regular session of the State legislature.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
Llama 3.2 · runs locally in your browser
Ask anything about this bill. The AI reads the full text to answer.
Enter to send · Shift+Enter for new line