1. Short title
This Act may be cited as the “Insulin Access for All Act of 2019”.
Insulin Access for All Act of 2019
A BILL
To amend titles XVIII and XIX of the Social Security Act to eliminate cost sharing with respect to coverage of insulin as a covered part D drug under the Medicare program or as a covered outpatient drug under the Medicaid program.
2. Eliminating cost sharing with respect to coverage of insulin as a covered part D drug under the Medicare program or as a covered outpatient drug under the Medicaid program
Medicare—
Elimination of cost-sharing for insulin and certain associated medical supplies furnished to part D eligible individuals— Section 1860D–2 of the Social Security Act (42 U.S.C. 1395w–102) is amended—
in subsection (b)—
in paragraph (1)(A), by striking “The coverage” and inserting “Subject to paragraph (8), the coverage”;
in paragraph (2)—
in subparagraph (A), by inserting after “Subject to subparagraphs (C) and (D)” the following: “and paragraph (8)”;
in subparagraph (C)(i), by striking “paragraph (4)” and inserting “paragraphs (4) and (8)”; and
in subparagraph (D)(i), by striking “paragraph (4)” and inserting “paragraphs (4) and (8)”;
in paragraph (4)(A)(i), by striking “The coverage” and inserting “Subject to paragraph (8), the coverage”; and
by adding at the end the following new paragraph:
“(8) Elimination of cost-sharing for certain covered part D drugs—The coverage does not impose any deductible, copayment, coinsurance, or other cost-sharing for insulin (as described in subparagraph (B) of subsection (e)(1)) or medical supplies associated with the injection of insulin (as described in such subparagraph).”
in subsection (c), by adding at the end the following new paragraph:
“(4) Same elimination of cost-sharing for certain covered part D drugs—The coverage is in accordance with subsection (b)(8).”
Elimination of cost-sharing for insulin and certain associated medical supplies furnished to part D eligible individuals who are subsidy eligible individuals— Section 1860D–14(a) of the Social Security Act (42 U.S.C. 1395w–114(a)) is amended—
in paragraph (1)—
in subparagraph (D)—
in clause (ii), by striking “In the case of” and inserting “Subject to subparagraph (F), in the case of”; and
in clause (iii), by striking “In the case of” and inserting “Subject to subparagraph (F), in the case of”; and
by adding at the end the following new subparagraph:
“(F) Elimination of cost-sharing for certain covered part D drugs—Coverage that is in accordance with section 1860D–2(b)(8).”
in paragraph (2)—
in subparagraph (D), by striking “The substitution” and inserting “Subject to subparagraph (F), the substitution”;
in subparagraph (E), by inserting after “Subject to” the following: “subparagraph (F) and”; and
by adding at the end the following new subparagraph:
“(F) Elimination of cost-sharing for certain covered part D drugs—Coverage that is in accordance with section 1860D–2(b)(8).”
Applicability— The amendments made by this subsection shall apply with respect to insulin, and medical supplies associated with the injection of insulin, furnished on or after January 1, 2020.
Medicaid—
in subsection (a)(2)—
in subparagraph (D), by striking “or” at the end;
in subparagraph (E), by striking “; and” and inserting “, or”; and
by adding at the end the following new subparagraph:
“(F) insulin furnished as a covered outpatient drug (as defined in section 1927(k)(2)) and medical supplies associated with the injection of such insulin; and”
in subsection (b)(2)—
in subparagraph (D), by striking “or” at the end;
in subparagraph (E), by striking “; and” and inserting “, or”; and
by adding at the end the following new subparagraph:
“(F) insulin furnished as a covered outpatient drug (as defined in section 1927(k)(2)) and medical supplies associated with the injection of such insulin; and”
Alternative cost sharing limitation— Section 1916A(c)(2) of the Social Security Act (42 U.S.C. 13960–1(c)(2)) is amended by adding at the end the following new subparagraph:
“(D) Nonapplicability of cost sharing to insulin—In no case may the cost sharing under paragraph (1)(A) apply with respect to insulin furnished as a covered outpatient drug (as defined in section 1927(k)(2)) and medical supplies associated with the injection of such insulin.”
Effective date—
In general— Subject to subparagraph (B), the amendments made by this subsection shall apply with respect to covered outpatient drugs furnished on or after January 1, 2020.
Exception for State legislation— In the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) that the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this subsection, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.