Republican senator tells constituents he supports $35 insulin cap, days after voting against it

Chuck Grassley voted against Inflation Reduction Act, which caps Medicare patients’ out-of-pocket costs, as well as an amendment to lower insulin costs for other patients

Republican Senator Chuck Grassley told a group of his constituents in Iowa that he supports the “$35 cap” on insulin, part of a larger prescription drug and healthcare legislative package that aims to cut monthly out-of-pocket drug costs for millions of Americans with diabetes.

But he voted against the idea earlier this month.

The cap was initially included in congressional Democrats’ Inflation Reduction Act, a major piece of President Joe Biden’s domestic agenda that, among other things, intends to lower the costs of prescription drugs. It passed on a party-line vote in the upper chamber, with all Republicans voting against it.

In a video shared by Iowa Starting Line on 17 August, Senator Grassley says he is “for the $35 cap” then argues that capping insulin costs does not limit the role of pharmacy benefit managers, the companies that manage drug pricing benefits on behalf of health insurance companies and federal- and state-level plans.

The Inflation Reduction Act limits monthly insulin copays to $35 for Medicare beneficiaries beginning next year, while also capping annual out-of-pocket costs for older Americans insured by the federal health programme at $2,000.

Democrats advanced the bill through budget reconciliation, a process that allowed for its passage with a simple majority vote in the evenly divided Senate.

But through that process, the Senate parliamentarian – an unelected rules-guiding official – established that a broader insulin cap for non-Medicare patients could not be included. Democratic senators sought a 60-vote majority to pass an amendment that would include non-Medicare patients in the bill, but the provision fell short by a vote of 57-32. Only seven Republicans joined Democrats to support that amendment.

Senator Grassley voted against it.

He supported an earlier amendment from Louisiana Republican Senator John Neely Kennedy that would provide discounted insulin to only a narrow pool of lower-income patients through federally supported health clinics.

Senator Grassley was among the Senate’s 50 Republicans to vote against the final version of the bill on 7 August.

“There was a chance to cap that insulin at $35 for everybody in that bill, and it didn’t pass,” a constituent is heard telling Senator Grassley in the town hall video.

“It would have just capped it for the people that are on commercial health insurance,” he replied. “It wouldn’t have done anything for the uninsured.”

“But that would’ve been something,” the constituent said.