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VERIFYING the difference between $35 insulin caps under Biden and Trump

Both the Trump and Biden administrations enacted $35 insulin price caps for certain Medicare recipients. Trump’s was first, but Biden’s applies to more people.

Millions of Americans have diabetes, a chronic disease that affects how a person’s body turns food into energy. Many of those living with diabetes need insulin to survive, but the price of the medication in the United States is often expensive.

That’s why the federal government and several drug companies have been working to lower insulin costs over the past several years, including instituting a monthly $35 cap for some insulin users.

On Aug. 14, former President Donald Trump claimed responsibility for capping insulin prices at $35 while he was in office during a campaign rally in Asheville, North Carolina.

“Kamala and Joe tried to take credit for $35 insulin. You know who did that? I did that. I did the insulin,” Trump claimed. He made a similar claim on Truth Social in June.

But Vice President Kamala Harris’ presidential campaign said in an X post that Trump’s claims are false.

“This is a blatant lie. Trump did not cap insulin costs, Biden-Harris did for seniors through the Inflation Reduction Act. Trump’s Project 2025 wants to repeal it, which would raise insulin costs for over a million Americans,” the post said.

VERIFY readers Debbie and Marianne want to know if the Trump administration is responsible for capping insulin costs at $35.

THE QUESTION

Is the Trump administration responsible for capping insulin prices at $35?

THE SOURCES

THE ANSWER

This needs context.

Both the Trump and Biden administrations instituted $35 insulin caps for certain Medicare patients. But Biden’s caps cover more seniors on Medicare than Trump’s did.

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WHAT WE FOUND

Former President Donald Trump’s and President Joe Biden’s administrations achieved $35 insulin copay caps for Medicare patients. However, Biden’s caps cover more seniors on Medicare than Trump’s did.

In July 2020, Trump signed an executive order that established the “Part D Senior Savings Model,” a voluntary program run by the Centers for Medicare & Medicaid Services (CMS) that temporarily lowered the monthly costs of insulin to $35 for some Medicare patients who were enrolled in Part D prescription drug plans. Medicare Part D is an optional plan offered to everyone with Medicare that helps cover the cost of prescription drugs, according to Medicare.gov.

Under this model, participating Medicare Part D prescription drug plans covered at least one of each dosage form and type of insulin product at no more than $35 per month, KFF says. The model was in effect from 2021 through 2023, and less than half of all Part D plans chose to participate in the program.

In August 2022, President Joe Biden signed the Inflation Reduction Act into law. The Inflation Reduction Act included a provision that requires all Part D plans to charge no more than $35 per month for all covered insulin products and also limits cost-sharing, or patients’ out-of-pocket costs, for insulin covered under Part B to $35 per month, according to KFF.

Medicare Part B is an optional plan that helps cover medical services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, such as insulin pumps, and many preventive services, like screenings, shots or vaccines and yearly “wellness” visits.

The Inflation Reduction Act’s mandatory $35 monthly cap took effect in Jan. 2023 for Part D and July 2023 for Part B, and CMS phased out Trump’s voluntary program by the end of that year. CMS has acknowledged that the Biden administration’s cap “closely aligns with” the voluntary $35 monthly cap from Trump’s program.

CMS estimates that around 800,000 insulin users had access to $35 insulin copays under the Trump administration’s “Part D Senior Savings Model” in 2022. In contrast, over 3.3 million Medicare patients who take insulin have access to the $35-per-month copay cap under the Biden administration’s policy.

Vice President Kamala Harris has promised to lower the cost of insulin and prescription drugs for everyone if she becomes president. KFF says that the Biden administration and Senate Democrats included a similar provision in the Inflation Reduction Act, but it was stripped from the final legislation after the vast majority of Republicans voted to remove it.

The House Republican Study Committee proposed a full repeal of the Inflation Reduction Act in its FY2025 budget proposal, according to KFF. It’s unclear if Trump supports repealing the law in its entirety. VERIFY reached out to the Trump campaign for comment but did not hear back by the time of publication.

The Associated Press contributed to this report

This story is also available in Spanish / Lee este artículo también en español: Verificamos la diferencia entre los límites de 35 dólares de la insulina bajo Biden y Trump

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