HHS report finds Inflation Reduction Act’s US$35 cap on month’s supply of insulin would have saved people with Medicare about US$500 on their insulin costs in 2020; the Act’s insulin provision went into effect January 1, 2023 for Medicare Part D

Sample article from our Health Care Sector

January 25, 2023 (press release) –

$35 monthly insulin cap in historic law, which went into effect January 1 for Medicare Part D, would have saved 1.5 million people with Medicare an average of $500 dollars on their insulin in 2020

Today, the U.S. Department of Health and Human Services (HHS) issued a new report showing the major savings coming to people with Medicare thanks to the $35 cap on a month’s supply of insulin. The report shows that if the Inflation Reduction Act’s provision capping the cost of insulin at $35 for a month’s supply for Medicare beneficiaries had been in place in 2020, 1.5 million seniors across the country would have saved an average of $500 on insulin for the year. Through the Inflation Reduction Act – the most consequential health care law since the Affordable Care Act – President Biden is delivering on his promise to lower prescription drug costs, make health insurance more affordable, and make the economy work for working families.

The insulin provisions of this historic law went into effect January 1, 2023, for Medicare Part D. Starting July 1, 2023, under Medicare Part B, beneficiary cost sharing will be limited to $35 for a month’s supply of insulin. Researchers estimate that 1.5 million people with Medicare would have benefited from the new Inflation Reduction Act insulin cost-sharing limits if they had been in effect in 2020, with total savings to beneficiaries of about $734 million in Part D and $27 million in Part B – an average savings of approximately $500 for those Medicare beneficiaries.

“The Biden-Harris Administration is committed to lowering health care costs and increasing access to high-quality, affordable health care, and the Inflation Reduction Act is helping us do just that,” said HHS Secretary Xavier Becerra. “Thanks to this historic law, people who get their insulin through Medicare won’t have to pay more than $35 for a month’s supply. No one should have to skip or ration their insulin because they can’t afford it.”

Produced by the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE), the report includes selected findings from a recent report to congress that examined the critical role that insulin plays in the treatment of diabetes, reviewed evidence on how insulin affordability affects adherence to insulin treatment and downstream health consequences, and described policy efforts to improve the affordability of insulin.

The new report also provides information on savings by state and by demographic characteristics, including gender, race and ethnicity, and age. The states with the most people with Medicare projected to benefit from the new Inflation Reduction Act insulin cost savings are Texas (114,000 beneficiaries), California (108,000), and Florida (90,000). North Dakota ($805), Iowa ($725), and South Dakota ($725) have the highest average annual out-of-pocket savings.

In 2019, about 37 percent of insulin fills for people with Medicare required cost-sharing exceeded $35 per fill, including 24 percent that exceeded $70 per fill.

Nationally, the average out-of-pocket cost was $58 per insulin fill in 2019, typically for a 30-day supply. Patients with private insurance or Medicare paid about $63 per fill on average.

The full HHS report, “Insulin Affordability and the Inflation Reduction Act: Medicare Beneficiary Savings by State and Demographics”, is available at https://aspe.hhs.gov/reports/insulin-affordability-data-point and the Report to Congress is available at: https://aspe.hhs.gov/reports/insulin-affordability-rtc

The state-by-state estimated savings and estimated number of Medicare individuals who would experience cost savings can be found below:

Estimated Out-of-Pocket Savings If Inflation Reduction Act $35 Out-of-Pocket Insulin Cap Had Been In Effect in 2020, by State

State Total Number of Enrollees in Part D and B Who Would Experience Savings Projected IRA Savings ($) Average Annual Out-of-Pocket Savings Per Enrollee ($)
Alabama 29,127 $12,800,687 $439
Alaska 1,026 $613,867 $598
Arizona 28,124 $14,545,058 $517
Arkansas 15,559 $8,395,598 $540
California 108,164 $36,622,758 $339
Colorado 16,085 $8,288,613 $515
Connecticut 11,444 $6,749,195 $590
Delaware 6,066 $2,707,378 $446
Florida 90,181 $42,920,606 $476
Georgia 45,625 $21,764,218 $477
Hawaii 3,703 $1,440,292 $389
Idaho 7,927 $4,801,119 $606
Illinois 59,718 $30,975,919 $519
Indiana 42,310 $22,876,374 $541
Iowa 18,834 $13,648,044 $725
Kansas 15,657 $10,170,650 $650
Kentucky 27,797 $12,590,086 $453
Louisiana 22,071 $9,095,485 $412
Maine 5,976 $3,169,201 $530
Maryland 21,052 $9,868,664 $469
Massachusetts 26,287 $13,248,195 $504
Michigan 66,726 $26,908,214 $403
Minnesota 27,128 $18,232,052 $672
Mississippi 15,366 $8,344,497 $543
Missouri 34,881 $18,256,529 $523
Montana 4,835 $2,913,023 $602
Nebraska 9,716 $6,576,898 $677
Nevada 10,769 $4,725,569 $439
New Hampshire 6,586 $3,533,326 $536
New Jersey 39,641 $20,239,433 $511
New Mexico 8,716 $3,856,841 $443
New York 75,601 $36,526,747 $483
North Carolina 56,921 $25,580,364 $449
North Dakota 4,527 $3,642,152 $805
Ohio 72,854 $36,536,703 $502
Oklahoma 19,556 $10,417,603 $533
Oregon 17,915 $10,586,279 $591
Pennsylvania 80,197 $43,565,423 $543
Rhode Island 4,678 $2,269,088 $485
South Carolina 31,235 $14,896,443 $477
South Dakota 4,568 $3,313,226 $725
Tennessee 39,562 $19,534,028 $494
Texas 114,242 $50,395,627 $441
Utah 11,393 $7,110,735 $624
Vermont 3,118 $2,153,816 $691
Virginia 36,461 $18,597,268 $510
Washington 28,063 $16,917,285 $603
Washington D.C. 650 $262,462 $404
West Virginia 12,656 $5,706,666 $451
Wisconsin 31,935 $20,064,260 $628
Wyoming 2,469 $1,597,721 $647

* All content is copyrighted by Industry Intelligence, or the original respective author or source. You may not recirculate, redistrubte or publish the analysis and presentation included in the service without Industry Intelligence's prior written consent. Please review our terms of use.

See our dashboard in action - schedule an demo
Dan Rivard
Dan Rivard
- VP Market Development -

We offer built-to-order health care sector coverage for our clients. Contact us for a free consultation.

About Us

We deliver market news & information relevant to your business.

We monitor all your market drivers.

We aggregate, curate, filter and map your specific needs.

We deliver the right information to the right person at the right time.

Our Contacts

1990 S Bundy Dr. Suite #380,
Los Angeles, CA 90025

+1 (310) 553 0008

About Cookies On This Site

We collect data, including through use of cookies and similar technology ("cookies") that enchance the online experience. By clicking "I agree", you agree to our cookies, agree to bound by our Terms of Use, and acknowledge our Privacy Policy. For more information on our data practices and how to exercise your privacy rights, please see our Privacy Policy.