[Congressional Record Volume 172, Number 75 (Wednesday, April 29, 2026)]
[Senate]
[Pages S2092-S2093]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          INSULIN ACT OF 2026

  Ms. COLLINS. Mr. President, I rise today to speak about a bill that 
Senator Shaheen and I introduced recently. It is called the Improving 
Needed Safeguards for Users of Lifesaving Insulin Now Act, or the 
INSULIN Act. This bill would make insulin more affordable for Americans 
with diabetes.
  I would like to also recognize the work of Senators Warnock and 
Kennedy who joined us in introducing this important bill.
  In 1997, I founded the Senate Diabetes Caucus after meeting with a 
family from Maine who had a 10-year-old son with type 1 diabetes.
  I will never forget this young boy looking up at me and saying to me 
that he wished that he could just take 1 day off from having type 1 
diabetes--his birthday or Christmas--just 1 day. But, of course, he 
could not.
  It was then that I knew that I had to dedicate my efforts toward 
earlier diagnosis, better treatments and technology, and one day a 
cure.
  Since 2009, Senator Shaheen and I have cochaired the Diabetes Caucus 
in the Senate and worked together to fund vital research and advance 
policies that will improve the lives of those who are living with 
diabetes. One of our top priorities has been to make insulin more 
affordable.
  Now, insulin was first isolated more than 100 years ago in Canada, 
and the scientist who did discover it gave away, essentially, the 
patent rights because they wanted insulin to be available and 
affordable to everyone who needed it.
  Tens of millions of Americans rely on insulin as part of their daily 
treatment

[[Page S2093]]

for their diabetes. For children, teens, and adults with type 1 
diabetes, insulin is not optional; it is literally a matter of life or 
death. About 20 percent of those with type 2 diabetes are also insulin-
dependent. While there are some exciting and extraordinary scientific 
breakthroughs in cell and gene therapy that may change this--and the 
sooner the better--the fact is that, today, people who are dependent on 
insulin still face great anxiety about its affordability.
  I have heard from far too many people across Maine and across this 
country who, because of the escalating costs of insulin, feel they have 
to ration their insulin and do not take the full dose that their 
physician has prescribed and that they need to be healthy.
  Let me tell you of one example.
  Bek Hoskins, of Chelsea, ME, is a young adult. Bek was forced to skip 
her doses of insulin to try to make it last longer, to stretch it out, 
because she simply could not afford the cost. In one profoundly 
memorable instance, Bek pushed her body's limit too far, and she ended 
up in the emergency room. Her husband Barrett rushed her, through a 
snowstorm, to the hospital, and she nearly died because she tried to go 
without insulin for 2 days. Such a dangerous, preventable crisis should 
never occur. We must address this life-threatening problem.
  Senator Shaheen and I have introduced legislation to reduce the price 
of insulin in the past two Congresses, and we have made some progress. 
For example, three of the biggest insulin manufacturers--Eli Lilly, 
Novo Nordisk, and Sanofi--voluntarily chose to cut their list prices. 
This is encouraging, but there is more work to be done. We also joined 
together for reforms in the pharmacy benefit manager system, which 
encouraged PBMs to choose the highest priced insulin for insurance 
formularies. That was because their compensation was frequently a 
percentage of the list price. Much of that we are fixing, and some of 
it was fixed last year. But we need more legislation to fix the 
fundamental problems in the insulin market, including limited 
biosimilar competition, as well as barriers to patients' access.
  The INSULIN Act would do just that. Our bill would limit cost sharing 
for insulin to no more than $35 a month, or 25 percent of the list 
price per month, for at least one type of insulin for each type that is 
needed and dosage form, for patients who have commercial insurance.
  Our bill would also prohibit insurers and pharmacy benefit managers 
from placing utilization obstacles such as prior authorization and step 
therapy on products that have capped costs. These important patient 
protections will deliver immediate out-of-pocket relief.
  The INSULIN Act of 2026 will also promote generic and biosimilar 
competition in the insurance market to further drive down prices 
through more competition. The bill would create a new, expedited FDA 
pathway to promote biosimilar competition. It would take similar steps 
to enhance regulatory certainty for biosimilar drug companies, such as 
by requiring the FDA to prioritize actions such as inspections and 
communications with manufacturers.
  We can't have a situation where a biosimilar, which is like a generic 
for insulin, is launched at a low price but faces obstacles to its 
approval even if it is absolutely identical to a brand-name insulin, 
and we can't allow--and we have seen this before--pharmacy benefit 
managers to refuse to choose that lower priced biosimilar product for 
the insurance company's formulary simply because they will make less on 
the deal.
  Finally, this bill helps address the insulin needs of uninsured 
Americans by creating a pilot grant program for States to implement to 
identify people with diabetes who are uninsured and provide them with 
insulin at $35 a month. It will also create an insulin resource center 
and a hotline for people with diabetes who are uninsured to help 
connect them with programs so that they can secure the insulin that 
they need in order to be healthy.
  The INSULIN Act will help make insulin more affordable for Americans, 
both those with and without insurance, by capping the cost and 
addressing fundamental flaws in the insulin market and the FDA approval 
process. I thank the American Diabetes Association, Breakthrough T1D, 
and the Endocrine Society for endorsing this much needed legislation.
  Let me just add one final point. If individuals who are insulin-
dependent are able to use their insulin, they not only are going to be 
healthier and avoid severe ramifications of not taking insulin; the 
healthcare system is going to save money. It is far less expensive to 
help people afford the insulin that they need for their diabetes than 
to have them hospitalized or at risk of losing a limb or becoming blind 
or having other severe consequences because they are not able to afford 
their insulin.
  So I would encourage my colleagues to join us in supporting this 
bipartisan and much needed legislation.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. CORNYN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Texas.

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