Republicans opposed Build Back Better as a whole, not necessarily insulin price caps, as post claims

Insulin prices have risen dramatically in recent years, and some of the estimated 34 million Americans who have diabetes are paying up to $1,000 a month for the life-saving drug.

But is it true that all Republicans in the U.S. Senate oppose an effort to cap prices for the drug at $35 per month? That’s what one Facebook post suggests.

"Biden and most Democrats want to cap insulin prices at $35 per month," read a Feb. 8 Facebook post that also noted that many Americans pay up to $1,000. "All 50 Republicans in the Senate are opposed to it."

The post was flagged as part of Facebook’s efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook.)

The situation is not as simple as the Facebook post suggests.

Legislators on both sides of the aisle have identified the rising cost of insulin as a problem. A 2020 study showed that the U.S. often pays as much as 10 times more than other countries in manufacturer prices for all forms of insulin. A 2018 Yale study showed 1 in 4 Americans rationed their insulin due to high costs.

President Joe Biden has spoken of the need to lower the cost of insulin. His Build Back Better plan, which did have wide support from Democrats, would have capped cost sharing for insulin at $35 a month for those on insurance plans, although it didn’t address costs for uninsured Americans.

It’s true that Republicans, urged by Senate Minority Leader Mitch McConnell, were united in opposition to passing the Democrats’ roughly $2 trillion Build Back Better Act. It was a Democrat, however, who sealed the bill’s fate before it came to a vote. 

The Democrats, in a 50-50 Senate, could have passed the bill on a simple majority vote via reconciliation and avoided the 60-vote threshold needed to end a filibuster. But Democratic Sen. Joe Manchin of West Virginia announced in late December that he couldn’t support the bill, citing its cost. He reiterated earlier this month in an interview with CNN that the bill, at least as a big package, is "dead."

Biden and other Democrats have expressed a willingness to pass parts of the Build Back Better Act in separate bills, leaving the door open for the proposed cap on insulin prices to be revived.

Before Manchin effectively killed the bill, the Washington Post in December reported that Senate Republicans were considering using a procedural move known as the "Byrd rule" to strip the drug-pricing legislation from the Build Back Better bill. The idea was to deny Democrats a talking point in the midterm elections, the Post reported.

Meanwhile, the publication STAT reported that two of the largest insulin makers greatly increased their spending on lobbying last year. So, passing caps on insulin prices is no sure thing.

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Vice Presidential nominee Tim Walz “says that if Democrats win they’ll make (U.S. Rep. Alexandria Ocasio-Cortez) speaker of the house.”

But one can’t rule out any Republican support based solely on opposition to the Build Back Better Act. Numerous Republicans, including many of those in the Senate, have indicated support for insulin price caps.

Former President Donald Trump announced a deal in 2020 that would let Medicare recipients choose plans that would cap insulin costs at $35, though with slightly higher premiums.

Maine Sen. Susan Collins, Iowa Sen. Chuck Grassley and Louisiana Sens. Bill Cassidy and John Kennedy have all expressed support or made efforts to lower the cost of insulin in the past. 

Kennedy in April 2021 proposed a bill that would have capped out-of-pocket insulin costs at $50 per month for people covered by health plans and also reimbursed those without insurance.

We asked his office if he would support a standalone bill capping costs at $35 and spokesperson Jess Andrews pointed us to legislation Kennedy proposed in September 2021. The Seniors Saving on Insulin Act would cap monthly insulin costs at $35 for those on Medicare.

According to the Washington Post, at least 19 Republican senators have previously signed on to legislation that would lower costs for diabetics. 

Grassley teamed with Oregon Sen. Ron Wyden to publish a Finance Committee report about the high cost of insulin in January 2021. They found that business practices between drug companies, health plans and pharmacy benefit managers helped keep the cost of the drug high, a claim PolitiFact rated as True in February 2021. Grassley did not respond to a request for comment about the proposed $35 cap for this article.

Collins, who is co-chair of the Senate Diabetes Caucus with Democrat Jeanne Shaheen, and Cassidy have also worked with Democrats on legislation to curb the rising price of insulin. Collins did not comment about whether she would support price caps, but the senator has worked with Shaheen to reduce insulin costs and expressed support for a price cap for some Medicare patients. 

Cassidy did not respond to requests for comment.

At the state level, there’s been bipartisan support to cap monthly insulin costs, including a bill that went into effect this year after passing the Republican-led Kentucky legislature. It is one of 15 states, and the District of Columbia, that have passed monthly price caps, according to the American Diabetes Association.

A social media post said that all 50 Senate Republicans are opposed to a proposal by Democrats to cap insulin prices at $35 a month.

Republicans did oppose Biden’s much larger Build Back Better plan, of which a $35 per month insulin price cap was one part. But we don’t see that that opposition was specific to the insulin measure. Several Republican senators have proposed or supported legislation meant to lower the cost of insulin in the past. 

The statement contains an element of truth but ignores critical facts that would give a different impression. We rate this claim Mostly False.

Staff researcher Caryn Baird contributed to this report.