According to the American Diabetes Association, an estimated two million New Yorkers and 650,000 people in New Jersey live with diabetes. From 2001 to 2019, the price of a one-month supply of insulin rose from $35 to $275. Surveys show one in four people on insulin ration their supply of the vital glucose-controlling hormone. Failing to take the correct amount of insulin over an extended period can damage multiple organ systems.

Last year, New York and Connecticut were among 10 states to cap out-of-pocket costs for insulin on state-regulated health plans. Two additional states—Colorado and Illinois—passed such legislation before 2020.

Under New York’s new law, people with these plans spend no more than $100 per month on deductibles and copays for each insulin prescription. But in Connecticut, the monthly cap is $25. 

Democrats in Albany are now pushing to revisit the legislation and pass a new bill to lower the cap to $30. In Trenton, Democrats are shooting for a $50 cap.

“We’re talking about folks who require a life-sustaining medicine, which currently might not be available to them because of the way that it’s priced,” said Gustavo Rivera (D-Bronx), who is sponsoring the bill in the state Senate. “We want to make sure they have access to something without which they would not be able to live.”

The New York Health Plan Association, which represents commercial insurance plans in the state, opposes the bill Rivera is jointly sponsoring with Assemblymember Yuh-Lin Niou. Leslie Moran, Senior Vice President of the NYHPA, said caps do not address the underlying cause: drug companies’ hiking prices.

“Restricting cost-sharing levels doesn’t mean the drug costs less. It just means those manufacturer-imposed costs have to be absorbed elsewhere, which translates to higher monthly premiums,” Moran said. “In addition to failing to address the ever-escalating costs of medications, the bill misses the mark of trying to keep coverage affordable for all consumers.”