Insulin Access for All Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 366 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. IN THE HOUSE OF REPRESENTATIVES JANUARY 9, 2019 Mr. RUSH (for himself, Ms. CLARKE of New York, Ms. KELLY of Illinois, Ms. LEE of California, Ms. ADAMS, Mrs. WATSON COLEMAN, Mr. PAYNE, Mr. EVANS, Ms. FUDGE, Mrs. DEMINGS, Mr. BROWN of Maryland, Mr. SCOTT of Virginia, Mr. LAWSON of Florida, Mr. CLAY, Mr. DANNY K. DAVIS of Illinois, Ms. PRESSLEY, Mr. LEWIS, Mr. THOMPSON of Mis- sissippi, Mr. CLYBURN, Mr. RICHMOND, Ms. JACKSON LEE, Mr. BISHOP of Georgia, Mr. HORSFORD, Mr. JOHNSON of Georgia, Mr. BUTTERFIELD, Ms. WILSON of Florida, Mr. CARSON of Indiana, Mr. MCEACHIN, Mrs. BEATTY, Ms. PLASKETT, Ms. SEWELL of Alabama, Mr. DAVID SCOTT of Georgia, Ms. SCHAKOWSKY, and Ms. BASS) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the com- mittee concerned 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 Med- icaid program. VerDate Sep 11 2014 02:18 Jan 19, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H366.IH H366 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 366 IH Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Insulin Access for All 4 Act of 2019’’. 5 SEC. 2. ELIMINATING COST SHARING WITH RESPECT TO 6 COVERAGE OF INSULIN AS A COVERED PART 7 D DRUG UNDER THE MEDICARE PROGRAM 8 OR AS A COVERED OUTPATIENT DRUG 9 UNDER THE MEDICAID PROGRAM. 10 (a) MEDICARE.— 11 (1) ELIMINATION OF COST-SHARING FOR INSU- 12 LIN AND CERTAIN ASSOCIATED MEDICAL SUPPLIES 13 FURNISHED TO PART D ELIGIBLE INDIVIDUALS.— 14 Section 1860D–2 of the Social Security Act (42 15 U.S.C. 1395w–102) is amended— 16 (A) in subsection (b)— 17 (i) in paragraph (1)(A), by striking 18 ‘‘The coverage’’ and inserting ‘‘Subject to 19 paragraph (8), the coverage’’; 20 (ii) in paragraph (2)— 21 (I) in subparagraph (A), by in- 22 serting after ‘‘Subject to subpara- 23 graphs (C) and (D)’’ the following: 24 ‘‘and paragraph (8)’’; 25 VerDate Sep 11 2014 02:18 Jan 19, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H366.IH H366 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 366 IH (II) in subparagraph (C)(i), by 1 striking ‘‘paragraph (4)’’ and insert- 2 ing ‘‘paragraphs (4) and (8)’’; and 3 (III) in subparagraph (D)(i), by 4 striking ‘‘paragraph (4)’’ and insert- 5 ing ‘‘paragraphs (4) and (8)’’; 6 (iii) in paragraph (4)(A)(i), by strik- 7 ing ‘‘The coverage’’ and inserting ‘‘Subject 8 to paragraph (8), the coverage’’; and 9 (iv) by adding at the end the following 10 new paragraph: 11 ‘‘(8) ELIMINATION OF COST-SHARING FOR CER- 12 TAIN COVERED PART D DRUGS.—The coverage does 13 not impose any deductible, copayment, coinsurance, 14 or other cost-sharing for insulin (as described in 15 subparagraph (B) of subsection (e)(1)) or medical 16 supplies associated with the injection of insulin (as 17 described in such subparagraph).’’; and 18 (B) in subsection (c), by adding at the end 19 the following new paragraph: 20 ‘‘(4) SAME ELIMINATION OF COST-SHARING FOR 21 CERTAIN COVERED PART D DRUGS.—The coverage is 22 in accordance with subsection (b)(8).’’. 23 (2) ELIMINATION OF COST-SHARING FOR INSU- 24 LIN AND CERTAIN ASSOCIATED MEDICAL SUPPLIES 25 VerDate Sep 11 2014 02:18 Jan 19, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H366.IH H366 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 366 IH FURNISHED TO PART D ELIGIBLE INDIVIDUALS WHO 1 ARE SUBSIDY ELIGIBLE INDIVIDUALS.—Section 2 1860D–14(a) of the Social Security Act (42 U.S.C. 3 1395w–114(a)) is amended— 4 (A) in paragraph (1)— 5 (i) in subparagraph (D)— 6 (I) in clause (ii), by striking ‘‘In 7 the case of’’ and inserting ‘‘Subject to 8 subparagraph (F), in the case of’’; 9 and 10 (II) in clause (iii), by striking 11 ‘‘In the case of’’ and inserting ‘‘Sub- 12 ject to subparagraph (F), in the case 13 of’’; and 14 (ii) by adding at the end the following 15 new subparagraph: 16 ‘‘(F) ELIMINATION OF COST-SHARING FOR 17 CERTAIN COVERED PART D DRUGS.—Coverage 18 that is in accordance with section 1860D– 19 2(b)(8).’’; and 20 (B) in paragraph (2)— 21 (i) in subparagraph (D), by striking 22 ‘‘The substitution’’ and inserting ‘‘Subject 23 to subparagraph (F), the substitution’’; 24 VerDate Sep 11 2014 02:18 Jan 19, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H366.IH H366 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 366 IH (ii) in subparagraph (E), by inserting 1 after ‘‘Subject to’’ the following: ‘‘subpara- 2 graph (F) and’’; and 3 (iii) by adding at the end the fol- 4 lowing new subparagraph: 5 ‘‘(F) ELIMINATION OF COST-SHARING FOR 6 CERTAIN COVERED PART D DRUGS.—Coverage 7 that is in accordance with section 1860D– 8 2(b)(8).’’. 9 (3) APPLICABILITY.—The amendments made 10 by this subsection shall apply with respect to insulin, 11 and medical supplies associated with the injection of 12 insulin, furnished on or after January 1, 2020. 13 (b) MEDICAID.— 14 (1) IN GENERAL.—Section 1916 of the Social 15 Security Act (42 U.S.C. 1396o) is amended— 16 (A) in subsection (a)(2)— 17 (i) in subparagraph (D), by striking 18 ‘‘or’’ at the end; 19 (ii) in subparagraph (E), by striking 20 ‘‘; and’’ and inserting ‘‘, or’’; and 21 (iii) by adding at the end the fol- 22 lowing new subparagraph: 23 ‘‘(F) insulin furnished as a covered out- 24 patient drug (as defined in section 1927(k)(2)) 25 VerDate Sep 11 2014 02:18 Jan 19, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H366.IH H366 pamtmann on DSKBFK8HB2PROD with BILLS 6 •HR 366 IH and medical supplies associated with the injec- 1 tion of such insulin; and’’; and 2 (B) in subsection (b)(2)— 3 (i) in subparagraph (D), by striking 4 ‘‘or’’ at the end; 5 (ii) in subparagraph (E), by striking 6 ‘‘; and’’ and inserting ‘‘, or’’; and 7 (iii) by adding at the end the fol- 8 lowing new subparagraph: 9 ‘‘(F) insulin furnished as a covered out- 10 patient drug (as defined in section 1927(k)(2)) 11 and medical supplies associated with the injec- 12 tion of such insulin; and’’. 13 (2) ALTERNATIVE COST SHARING LIMITA- 14 TION.—Section 1916A(c)(2) of the Social Security 15 Act (42 U.S.C. 13960–1(c)(2)) is amended by add- 16 ing at the end the following new subparagraph: 17 ‘‘(D) NONAPPLICABILITY OF COST SHAR- 18 ING TO INSULIN.—In no case may the cost 19 sharing under paragraph (1)(A) apply with re- 20 spect to insulin furnished as a covered out- 21 patient drug (as defined in section 1927(k)(2)) 22 and medical supplies associated with the injec- 23 tion of such insulin.’’. 24 (3) EFFECTIVE DATE.— 25 VerDate Sep 11 2014 02:18 Jan 19, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H366.IH H366 pamtmann on DSKBFK8HB2PROD with BILLS 7 •HR 366 IH (A) IN GENERAL.—Subject to subpara- 1 graph (B), the amendments made by this sub- 2 section shall apply with respect to covered out- 3 patient drugs furnished on or after January 1, 4 2020. 5 (B) EXCEPTION FOR STATE LEGISLA- 6 TION.—In the case of a State plan under title 7 XIX of the Social Security Act (42 U.S.C. 1396 8 et seq.) that the Secretary of Health and 9 Human Services determines requires State leg- 10 islation in order for the respective plan to meet 11 any requirement imposed by amendments made 12 by this subsection, the respective plan shall not 13 be regarded as failing to comply with the re- 14 quirements of such title solely on the basis of 15 its failure to meet such an additional require- 16 ment before the first day of the first calendar 17 quarter beginning after the close of the first 18 regular session of the State legislature that be- 19 gins after the date of the enactment of this Act. 20 For purposes of the previous sentence, in the 21 case of a State that has a 2-year legislative ses- 22 sion, each year of the session shall be consid- 23 VerDate Sep 11 2014 02:18 Jan 19, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H366.IH H366 pamtmann on DSKBFK8HB2PROD with BILLS 8 •HR 366 IH ered to be a separate regular session of the 1 State legislature. 2 Æ VerDate Sep 11 2014 02:18 Jan 19, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\H366.IH H366 pamtmann on DSKBFK8HB2PROD with BILLS