Floor SpeechBipartisan2026-04-29

INSULIN ACT OF 2026

HealthcareTaxesForeign PolicyTrade

Context

On 2026-04-29, Senator Susan M. Collins (R-ME) delivered a floor speech titled "INSULIN ACT OF 2026" in the Senate. The speech addressed healthcare and also covered taxes, foreign policy. It referenced legislation including S2092, S2093.

Full Text

INSULIN ACT OF 2026

Congressional Record, Volume 172 Issue 75 (Wednesday, April 29, 2026) [Congressional Record Volume 172, Number 75 (Wednesday, April 29, 2026)] [Senate] [Pages S2092-S2093] From the Congressional Record Online through the Government Publishing Office [ www.gpo.gov ] INSULIN ACT OF 2026 Ms. COLLINS. Mr. President, I rise today to speak about a bill that Senator Shaheen and I introduced recently. It is called the Improving Needed Safeguards for Users of Lifesaving Insulin Now Act, or the INSULIN Act. This bill would make insulin more affordable for Americans with diabetes. I would like to also recognize the work of Senators Warnock and Kennedy who joined us in introducing this important bill. In 1997, I founded the Senate Diabetes Caucus after meeting with a family from Maine who had a 10-year-old son with type 1 diabetes. I will never forget this young boy looking up at me and saying to me that he wished that he could just take 1 day off from having type 1 diabetes--his birthday or Christmas--just 1 day. But, of course, he could not. It was then that I knew that I had to dedicate my efforts toward earlier diagnosis, better treatments and technology, and one day a cure. Since 2009, Senator Shaheen and I have cochaired the Diabetes Caucus in the Senate and worked together to fund vital research and advance policies that will improve the lives of those who are living with diabetes. One of our top priorities has been to make insulin more affordable. Now, insulin was first isolated more than 100 years ago in Canada, and the scientist who did discover it gave away, essentially, the patent rights because they wanted insulin to be available and affordable to everyone who needed it. Tens of millions of Americans rely on insulin as part of their daily treatment [[Page S2093]] for their diabetes. For children, teens, and adults with type 1 diabetes, insulin is not optional; it is literally a matter of life or death. About 20 percent of those with type 2 diabetes are also insulin- dependent. While there are some exciting and extraordinary scientific breakthroughs in cell and gene therapy that may change this--and the sooner the better--the fact is that, today, people who are dependent on insulin still face great anxiety about its affordability. I have heard from far too many people across Maine and across this country who, because of the escalating costs of insulin, feel they have to ration their insulin and do not take the full dose that their physician has prescribed and that they need to be healthy. Let me tell you of one example. Bek Hoskins, of Chelsea, ME, is a young adult. Bek was forced to skip her doses of insulin to try to make it last longer, to stretch it out, because she simply could not afford the cost. In one profoundly memorable instance, Bek pushed her body's limit too far, and she ended up in the emergency room. Her husband Barrett rushed her, through a snowstorm, to the hospital, and she nearly died because she tried to go without insulin for 2 days. Such a dangerous, preventable crisis should never occur. We must address this life-threatening problem. Senator Shaheen and I have introduced legislation to reduce the price of insulin in the past two Congresses, and we have made some progress. For example, three of the biggest insulin manufacturers--Eli Lilly, Novo Nordisk, and Sanofi--voluntarily chose to cut their list prices. This is encouraging, but there is more work to be done. We also joined together for reforms in the pharmacy benefit manager system, which encouraged PBMs to choose the highest priced insulin for insurance formularies. That was because their compensation was frequently a percentage of the list price. Much of that we are fixing, and some of it was fixed last year. But we need more legislation to fix the fundamental problems in the insulin market, including limited biosimilar competition, as well as barriers to patients' access. The INSULIN Act would do just that. Our bill would limit cost sharing for insulin to no more than $35 a month, or 25 percent of the list price per month, for at least one type of insulin for each type that is needed and dosage form, for patients who have commercial insurance. Our bill would also prohibit insurers and pharmacy benefit managers from placing utilization obstacles such as prior authorization and step therapy on products that have capped costs. These important patient protections will deliver immediate out-of-pocket relief. The INSULIN Act of 2026 will also promote generic and biosimilar competition in the insurance market to further drive down prices through more competition. The bill would create a new, expedited FDA pathway to promote biosimilar competition. It would take similar steps to enhance regulatory certainty for biosimilar drug companies, such as by requiring the FDA to prioritize actions such as inspections and communications with manufacturers. We can't have a situation where a biosimilar, which is like a generic for insulin, is launched at a low price but faces obstacles to its approval even if it is absolutely identical to a brand-name insulin, and we can't allow--and we have seen this before--pharmacy benefit managers to refuse to choose that lower priced biosimilar product for the insurance company's formulary simply because they will make less on the deal. Finally, this bill helps address the insulin needs of uninsured Americans by creating a pilot grant program for States to implement to identify people with diabetes who are uninsured and provide them with insulin at $35 a month. It will also create an insulin resource center and a hotline for people with diabetes who are uninsured to help connect them with programs so that they can secure the insulin that they need in order to be healthy. The INSULIN Act will help make insulin more affordable for Americans, both those with and without insurance, by capping the cost and addressing fundamental flaws in the insulin market and the FDA approval process. I thank the American Diabetes Association, Breakthrough T1D, and the Endocrine Society for endorsing this much needed legislation. Let me just add one final point. If individuals who are insulin- dependent are able to use their insulin, they not only are going to be healthier and avoid severe ramifications of not taking insulin; the healthcare system is going to save money. It is far less expensive to help people afford the insulin that they need for their diabetes than to have them hospitalized or at risk of losing a limb or becoming blind or having other severe consequences because they are not able to afford their insulin. So I would encourage my colleagues to join us in supporting this bipartisan and much needed legislation. I suggest the absence of a quorum. The PRESIDING OFFICER. The clerk will call the roll. The legislative clerk proceeded to call the roll. Mr. CORNYN. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded. The PRESIDING OFFICER. Without objection, it is so ordered. The Senator from Texas. ____________________

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INSULIN ACT OF 2026 Congressional Record, Volume 172 Issue 75 (Wednesday, April 29, 2026) [Congressional Record Volume 172, Number 75 (Wednesday, April 29, 2026)] [Senate] [Pages S2092-S2093] From the Congressional Record Online through the Government Publishing Office [ www.gpo.gov ] INSULIN ACT OF 2026 Ms. COLLINS. Mr. President, I rise today to speak about a bill that Senator Shaheen and I introduced recently. It is called the Improving Needed Safeguards for Users of Lifesaving Insulin Now Act, or the INSULIN Act. This bill would make insulin more affordable for Americans with diabetes. I would like to also recognize the work of Senators Warnock and Kennedy who joined us in introducing this important bill. In 1997, I founded the Senate Diabetes Caucus after meeting with a family from Maine who had a 10-year-old son with type 1 diabetes. I will never forget this young boy looking up at me and saying to me that he wished that he could just take 1 day off from having type 1 diabetes--his birthday or Christmas--just 1 day. But, of course, he could not. It was then that I knew that I had to dedicate my efforts toward earlier diagnosis, better treatments and technology, and one day a cure. Since 2009, Senator Shaheen and I have cochaired the Diabetes Caucus in the Senate and worked together to fund vital research and advance policies that will improve the lives of those who are living with diabetes. One of our top priorities has been to make insulin more affordable. Now, insulin was first isolated more than 100 years ago in Canada, and the scientist who did discover it gave away, essentially, the patent rights because they wanted insulin to be available and affordable to everyone who needed it. Tens of millions of Americans rely on insulin as part of their daily treatment [[Page S2093]] for their diabetes. For children, teens, and adults with type 1 diabetes, insulin is not optional; it is literally a matter of life or death. About 20 percent of those with type 2 diabetes are also insulin- dependent. While there are some exciting and extraordinary scientific breakthroughs in cell and gene therapy that may change this--and the sooner the better--the fact is that, today, people who are dependent on insulin still face great anxiety about its affordability. I have heard from far too many people across Maine and across this country who, because of the escalating costs of insulin, feel they have to ration their insulin and do not take the full dose that their physician has prescribed and that they need to be healthy. Let me tell you of one example. Bek Hoskins, of Chelsea, ME, is a young adult. Bek was forced to skip her doses of insulin to try to make it last longer, to stretch it out, because she simply could not afford the cost. In one profoundly memorable instance, Bek pushed her body's limit too far, and she ended up in the emergency room. Her husband Barrett rushed her, through a snowstorm, to the hospital, and she nearly died because she tried to go without insulin for 2 days. Such a dangerous, preventable crisis should never occur. We must address this life-threatening problem. Senator Shaheen and I have introduced legislation to reduce the price of insulin in the past two Congresses, and we have made some progress. For example, three of the biggest insulin manufacturers--Eli Lilly, Novo Nordisk, and Sanofi--voluntarily chose to cut their list prices. This is encouraging, but there is more work to be done. We also joined together for reforms in the pharmacy benefit manager system, which encouraged PBMs to choose the highest priced insulin for insurance formularies. That was because their compensation was frequently a percentage of the list price. Much of that we are fixing, and some of it was fixed last year. But we need more legislation to fix the fundamental problems in the insulin market, including limited biosimilar competition, as well as barriers to patients' access. The INSULIN Act would do just that. Our bill would limit cost sharing for insulin to no more than $35 a month, or 25 percent of the list price per month, for at least one type of insulin for each type that is needed and dosage form, for patients who have commercial insurance. Our bill would also prohibit insurers and pharmacy benefit managers from placing utilization obstacles such as prior authorization and step therapy on products that have capped costs. These important patient protections will deliver immediate out-of-pocket relief. The INSULIN Act of 2026 will also promote generic and biosimilar competition in the insurance market to further drive down prices through more competition. The bill would create a new, expedited FDA pathway to promote biosimilar competition. It would take similar steps to enhance regulatory certainty for biosimilar drug companies, such as by requiring the FDA to prioritize actions such as inspections and communications with manufacturers. We can't have a situation where a biosimilar, which is like a generic for insulin, is launched at a low price but faces obstacles to its approval even if it is absolutely identical to a brand-name insulin, and we can't allow--and we have seen this before--pharmacy benefit managers to refuse to choose that lower priced biosimilar product for the insurance company's formulary simply because they will make less on the deal. Finally, this bill helps address the insulin needs of uninsured Americans by creating a pilot grant program for States to implement to identify people with diabetes who are uninsured and provide them with insulin at $35 a month. It will also create an insulin resource center and a hotline for people with diabetes who are uninsured to help connect them with programs so that they can secure the insulin that they need in order to be healthy. The INSULIN Act will help make insulin more affordable for Americans, both those with and without insurance, by capping the cost and addressing fundamental flaws in the insulin market and the FDA approval process. I thank the American Diabetes Association, Breakthrough T1D, and the Endocrine Society for endorsing this much needed legislation. Let me just add one final point. If individuals who are insulin- dependent are able to use their insulin, they not only are going to be healthier and avoid severe ramifications of not taking insulin; the healthcare system is going to save money. It is far less expensive to help people afford the insulin that they need for their diabetes than to have them hospitalized or at risk of losing a limb or becoming blind or having other severe consequences because they are not able to afford their insulin. So I would encourage my colleagues to join us in supporting this bipartisan and much needed legislation. I suggest the absence of a quorum. The PRESIDING OFFICER. The clerk will call the roll. The legislative clerk proceeded to call the roll. Mr. CORNYN. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded. The PRESIDING OFFICER. Without objection, it is so ordered. The Senator from Texas. ____________________