NEW YORK — Senators Jeanne Shaheen, Raphael Warnock, Susan Collins and John Kennedy introduced the INSULIN Act last week, a bill that would cap the cost of insulin at $35 per month for Americans with private insurance plans. The legislation would also start a pilot program to provide more affordable insulin to uninsured Americans in 10 states.

About 8.1 million people in the United States use insulin, and more than 2 million have Type 1 diabetes and will die without regular access to it, according to the U.S. Centers for Disease Control and Prevention. Some people with private insurance pay zero or very little for insulin, while others pay hundreds of dollars each month on insulin alone.

A bill passed in 2022 as part of the Inflation Reduction Act capped insulin costs at $35 per month for Medicare beneficiaries, but that cap did not extend to those with private coverage. The House passed a $35 monthly insulin cap for Americans with private insurance in 2022, but it did not pass the Senate. An attempt to include such a cap in the Inflation Reduction Act failed after Republicans opposed it on the basis that it violated Senate rules.

More than half of U.S. states have passed insulin co-pay caps ranging from $25 to $100 per month for patients with state-regulated insurance plans. However, about 57 percent of Americans with private health insurance have self-insured plans that states cannot regulate, according to the Brookings Institution's Center on Health Policy.

Eli Lilly, Sanofi and Novo Nordisk have cut insulin costs by reducing list prices, capping out-of-pocket costs and expanding affordability programs. Some patients, however, are uninsured or have difficulty accessing manufacturers' cost-savings programs.

Dr. Leslie Eiland, an adult endocrinologist at the University of Nebraska Medical Center, said the current system places the burden on individuals. "It puts the onus on the patient, I think, to try to navigate and get the cost down," Eiland said.

"We look forward to working with policymakers to ensure middlemen don't stand between patients and their medicines," said Chanse Jones, a spokesperson for PhRMA.

Two-year-old Bain Brandon from Mississippi has Type 1 diabetes and needs insulin to live. A one-month supply of insulin vials and a three-month supply of backup pens cost $194 last week for his parents, according to his mom.

Breana Glover, a 23-year-old restaurant server in Houston, moved from California to Texas to find cheaper living expenses to cover health costs associated with her Type 1 diabetes. To afford a $50 co-pay for four vials of insulin, Glover limits her carbohydrate intake so she can use less insulin each day. "A $35 per month cap would be a small step towards everything becoming even more accessible," Glover said.