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Sen. Menendez and Rep. Payne, Jr. join with seniors, advocates to discuss impact of $35/month insulin price cap for seniors on Medicare

Price cap was implemented as part of the Inflation Reduction Act and took effect Jan. 1, 2023; Approximately 77,000 NJ Medicare beneficiaries used insulin in 2020

NEW JERSEY – U.S. Senator Bob Menendez (D-N.J.) and Congressman Donald Payne, Jr. (D-N.J.-10), Tuesday joined medical professionals, advocates and seniors to discuss the impact that the $35/month price cap on insulin is having on seniors on Medicare.

The price cap was implemented through the Inflation Reduction Act which passed Congress in August and took effect on Jan. 1, 2023.

“Last year, as part of the historic Inflation Reduction Act, I was proud to support a cap on the cost of insulin for seniors on Medicare at just $35 a month. In fact, we had a measure in place to cap the cost of insulin for ALL patients—for every American regardless of their insurance—only to have it struck down at the last minute,” Menendez said. “Despite this setback, we are continuing to fight. We’re continuing to advocate for every patient, for every beneficiary, so that no American is ever gouged by the price of insulin again.”

“I am proud that the Inflation Reduction Act is reducing the price of insulin for millions of Medicare beneficiaries,” Payne, Jr said.  “But we must do everything we can to allow all American diabetics to benefit from the law’s $35 cap on insulin payments.  As a diabetic and insulin user, this is medication we need to stay alive.  American companies have been overcharging for insulin and profiting off the backs of diabetics for years.  It forces too many of them to choose between food or medicine. No American should have to make that choice.”

Sen. Menendez also co-sponsored the Affordable Insulin Now Act last Congress which would cap out-of-pocket costs for insulin products at $35/month for all Americans and is continuing to push for this legislation so that no family has to choose between life-saving medication for themselves or a loved one and food, housing, or other essentials.

Earlier this month, Eli Lilly – one of the largest insulin manufacturers – announced that they would be lowering the cost for two of their insulin products to $35/month, showing that the steps taken by Congress are having a cascading effect on the private market.

“Diabetes Is a leading cause of death for residents in our community, affecting 16% of Newark residents. University Hospital’s work with the community demonstrates that chronic illnesses, like diabetes, place tremendous financial stress on those already dealing with pervasive socioeconomic hardship,” said Ed Jimenez, President and CEO of University Hospital. “Whether it’s offering free testing or working with patients to address financial issues, the UH family works diligently each day to help patients address their diabetes diagnosis. Our community members should never have to choose between getting insulin and putting food on their family’s table.”

“We have all heard stories about senior citizens who cannot afford their prescriptions and struggle balancing the costs of medicine, food, and housing,” said Cathy Rowe, DrPh., Executive Director of NJ Advocates for Aging Well. “This should not be the case for seniors in the United States, especially not when the doctor who discovered insulin 100 years ago made it clear that he wanted this life saving treatment to be available and affordable to everyone who needed it. I want to thank Senator Menendez and Congressman Payne and everyone who fought for this legislation and continues to fight to make insulin affordable for all.”

In addition to capping the price of insulin to $35/month for seniors on Medicare, the Inflation Reduction Act also capped Medicare beneficiaries’ out-of-pocket costs at $2,000 a year, with the ability to spread the cost over monthly payments – a provision authored by Sen. Menendez.

The bill will require Part D plans to offer improved financial protections that would phase in starting in 2024, with the $2,000 out-of-pocket cap taking effect in 2025. Each year, that will benefit about 46,000 New Jersey Medicare beneficiaries who would otherwise have out-of-pocket costs above the cap, according to estimates from the Kaiser Family Foundation (KFF). And, for the first time, all 1.2 million New Jerseyans with Medicare Part D will have the peace of mind of knowing their pharmacy costs are capped.

Jay Edwards

Born and raised in Northwest NJ, Jay has a degree in Communications and has had a life-long interest in local radio and various styles of music. Jay has held numerous jobs over the years such as stunt car driver, bartender, voice-over artist, traffic reporter (award winning), NY Yankee maintenance crewmember and peanut farm worker. His hobbies include mountain climbing, snowmobiling, cooking, performing stand-up comedy and he is an avid squirrel watcher. Jay has been a guest on America’s Morning Headquarters,program on The Weather Channel, and was interviewed by Sam Champion.

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