S. 4512 — Affordable Insulin Now Act of 2026

This section requires group health plans and health insurance issuers to cover selected insulin products without any deductible and with cost-sharing limited to the lesser of $35 or 25 percent of the negotiated price net of all concessions per 30-day supply, for plan years beginning on or after January 1, 2027. It excludes the deductible exemption from actuarial value calculations for qualified health plans, requires coverage of such products under catastrophic plans before the annual out-of-pocket limit is reached, and imposes identical requirements on ERISA plans.

This section establishes a program under which the Secretary of Health and Human Services reimburses qualifying health care providers and pharmacies for insulin products furnished to uninsured individuals. For each 30-day supply provided on or after January 1, 2027, the Secretary pays the difference between the individual's out-of-pocket cost and $35, provided the entity does not hold the individual liable for any additional amount.