Biden sees $35 price cap for insulin as pivotal campaign issue. It’s not clear-cut.

WASHINGTON — Rarely a day goes by without President Joe Biden mentioning insulin prices.

He is promoting a $35 drug price cap for Americans who get Medicare — in speeches at the White House, campaign stops and even at non-healthcare events around the country. His reelection team has flooded the swing state airwaves with ads stating this, in English and Spanish.

All this would apparently have a profound political and economic impact. The reality is more complicated.

As his campaign tries to highlight what it sees as an advantage over presumptive Republican nominee Donald Trump, Biden often exaggerates what those eligible for the price cap once paid for insulin. It’s also not clear whether the number of Americans helped will be enough to influence the November election, which could amount to a few thousand votes even in the most contentious states.

“It’s much more about political signals in a campaign than about showing people that the insulin limit will benefit them,” said Drew Altman, president and CEO of KFF, a nonprofit that researches health care issues. “It is a way to make it concrete that you are a healthcare candidate.”

Many who benefit from the price cap were already receiving insulin at reduced prices, were already Biden supporters, or both. Others who need insulin at a lower price, meanwhile, can’t get it because they don’t have Medicare or private health insurance.

Biden’s campaign is highlighting the president’s successful efforts to lower insulin prices and contrasting them with Trump, who first ran for president promising to lower drug prices but took limited action while in office.

“It’s a powerful and palpable contrast,” said Biden campaign spokesman Charles Lutvak. “And it is one that we are campaigning for early, aggressively and across our coalition.”

About 8.4 million people in the United States control their blood sugar levels with insulin, and more than 1 million people have type 1 diabetes and could die without regular access to it. The White House says nearly 4 million seniors will qualify for the new, lower price.

The price cap for Medicare recipients was part of the Inflation Reduction Act, which originally aimed to cap insulin at $35 for everyone with health insurance. When it passed in 2022, it was scaled back by Republicans in Congress to apply only to older adults.

The Biden administration also announced agreements with drugmakers Sanofi, Novo Nordisk and Eli Lilly to cap insulin co-payments at $35 for people with private insurance. They account for more than 90% of the US insulin market.

But Biden keeps saying that many people paid up to $400 monthly, which is an exaggeration. A Department of Health and Human Services study released in December 2022 found that people with diabetes who were enrolled in Medicare or had private insurance paid an average of $452 per year, not monthly.

The high prices mentioned by the president mainly affected people without health insurance. But rates for the uninsured have fallen to record lows due to the Obama administration’s signature health care law and the Biden White House’s aggressive efforts to ensure that those eligible to enroll do so more often.

So in effect, one of the government’s policy initiatives undermines the economic case for another.

However, that effort has not reached everyone.

Yanet Martinez who lives in Phoenix and supports Biden. She doesn’t work and has no health insurance, but gets insulin for about $16 a month thanks to deep discounts at her local clinic.

The lower prices only apply if her husband, a landscaper, does not earn enough to exceed the monthly income limit. If he does, her insulin could jump to $500-plus, she said.

“I’ve heard people talk about the price of insulin going down. I haven’t seen it,” said Martinez, 42. “It should be uniform. There are a lot of people who can’t afford it and that makes things very difficult.”

Sen. Raphael Warnock, D-Ga., is sponsoring bipartisan legislation to make the $35 insulin limit universal, even for people without health insurance. In the meantime, he said, what has been accomplished by Medicare recipients and drug makers agreeing to lower their prices is “literally saving lives and saving people money.”

“This is a good policy because it puts people first rather than politics,” Warnock said. He said as he travels through Georgia, a crucial swing state in November, people say, “Thank you for doing this for me, or for someone in my life.” family.”

That includes people like Tommy Marshall, a 56-year-old financial services consultant in Atlanta who has health insurance. He was diagnosed with type 1 diabetes at the age of 45 and injects rapid-acting insulin several times a day. He paid about $250 for four- to eight-week medications last November, but saw the price drop by half in February after Novo Nordisk agreed to lower prices.

“If I were his political advisor, I would tell Biden to talk about it all the time,” said Marshall, a lifelong Democrat and longtime public advocate for lowering insulin prices, including for the advocacy group Protect Our Care Georgia.

Marshall said the price caps “have meaningful emotional resonance” and could influence a close election, but also conceded: “You’re talking about 18 to 65 year olds. I would imagine there are probably two or three other issues at play.”

“There might be someone sitting on the fence,” he added, “this might sway them.”

Geoff Garin, a pollster for Biden’s reelection campaign, said the insulin limit is one of the president’s top-performing issues. He said the data was “clear, consistent and overwhelming.”

Rich Fiesta, executive director of the Alliance for Retired Americans, which has endorsed Biden, called the insulin cap among older voters a strong issue for the president.

“For those who are convinced – and there still are, believe it or not – drug costs are a very important factor,” said Fiesta, whose group has 4.4 million members and advocates for health and economic security for the elderly.

Trump’s campaign did not respond to questions. But Theo Merkel, a senior fellow at the conservative Paragon Health Institute, countered that the insulin price cut is an example of “policy written to meet the talking points, rather than the other way around.”

Merkel, a Trump White House adviser on health policy, said insulin manufacturers have long favored caps on the amount policyholders pay because it gives them more leverage to secure higher prices from insurance companies.

The president’s health care approval ratings are among his highest on a range of issues, yet only 42% of American adults approve of Biden’s handling of health care, while 55% disapprove, according to a February poll from The Associated Press and the NORC Center. for Public Affairs research.

KFF found in its own December poll that 59% of American adults trust the Democratic Party will do a better job addressing health care affordability, compared to 39% of Republicans, even though only 26% of respondents in the same poll said they knew about the insulin price cap.

“In political terms, Democrats and Biden have an advantage on health care,” Altman said. “They put pressure on that.”