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Bipartisan efforts are underway in the Senate to advance additional COVID-19 funding and cap insulin prices for Medicare beneficiaries and some uninsured patients with diabetes. Naturally, there are bumps.

The $10 billion compromise, which is expected to pass, will sustain federal efforts to provide vaccines, antivirals and testing, but money for global coronavirus aid was dumped in negotiations. The $10 billion price tag was to be offset by cuts from previous pandemic relief program outlays, not just budget authority.

A bipartisan bill negotiated by Senators Jeanne Shaheen, D-New Hampshire, and Susan Collins, R-Maine, would eliminate rebates drug manufacturers pay to insurers and pharmacy benefit managers.

The largest “savings” – $2.3 billion – will come from a $3 billion aviation manufacturing job protection provision that has been under-subscribed. The Congressional Budget Office treated the unspent amount as a savings, even though it is money that never would have been spent.

Of the $700 million awarded, the largest single award went to Spirit AeroSystems, located in Wichita and a major supplier for Boeing. The $3 billion provision was part of the $1.9 trillion American Rescue Plan.

While there are enough votes to pass the additional COVID funding, a debate over border policy may delay a Senate vote until after the upcoming two-week congressional recess. Republicans and some Democrats want to retain a contentious policy imposed during the Trump presidency to expel asylum seekers and immigrants for public health reasons. President Biden removed the order for unaccompanied children and now proposes to end the order for all immigrants. 

Negotiations continue on a compromise to cap insulin prices at $35 per month for Medicare patients, with critics saying that doesn’t help diabetics without health insurance who pay almost $1,300 per year. Health officials say 10 million Americans suffer from diabetes and 17 percent are uninsured, the majority of whom pay the list price for insulin. 

A bipartisan bill negotiated by Senators Jeanne Shaheen, D-New Hampshire, and Susan Collins, R-Maine, would eliminate rebates drug manufacturers pay to insurers and pharmacy benefit managers, which they say inflates the list price diabetics pay for insulin.

Senators Tina Smith, D-Minnesota, and Kevin Cramer, R-North Dakota, introduced a bill in 2019 that would offer a 90-day supply of insulin for uninsured or underinsured people, penalize drug companies for increasing prices faster than the rate of inflation and shorten patent exclusivity for insulin and other biologics from 12 years to seven years. Smith still supports the provisions, but Cramer has backed off.

Senator Raphael Warnock, D-Georgia, and Congresswoman Angie Craig, D-Minnesota, are pushing provisions to lower the price of insulin charged by drug manufacturers. The Pharmaceutical Research and Manufacturers of America have previously supported caps on insured patient co-pays. Health insurers warn that limits on insulin pricing would shift costs to other patients and insurance ratepayers.

Senate Majority Leader Chuck Schumer, who wants legislation voted on by the end of April, said concepts from several sources could be combined into a final bill.