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AB 921

Relating to: cost-sharing cap on insulin.

2025-2026 Regular Session Introduced by Margaret Arney and 15 co-sponsors

Wisconsin bill limits patient out-of-pocket insulin costs to reduce financial barriers for diabetic residents requiring this life-sustaining medication.

Commissioner of Insurance report received pursuant to s.601.423(2), Wisconsin Statutes
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Bill Summary · AB 921

Legislative bill overview

AB 921 establishes a cost-sharing cap on insulin for Wisconsin residents with health insurance. The bill limits out-of-pocket expenses (copayments, coinsurance, and deductibles) that patients must pay for insulin to a specified amount per month or prescription. This follows similar legislation enacted in other states to address rising insulin costs.

Why is this important

Insulin is a life-sustaining medication for people with type 1 diabetes and many with type 2 diabetes, yet prices have tripled over the past two decades, forcing some patients to ration doses or skip payments. A cost-sharing cap directly reduces the financial burden on insulin-dependent Wisconsinites and improves medication adherence, which prevents serious health complications and reduces overall healthcare costs. This addresses a documented public health crisis affecting approximately 600,000+ Wisconsin residents with diabetes.

Potential points of contention

  • Insurance premium impacts: Insurers may argue that cost-sharing caps increase their claims costs, potentially leading to higher premiums for all enrollees rather than just insulin users
  • Coverage scope uncertainty: The bill's specific cap amount and whether it applies to all insurance types (individual, employer-sponsored, public plans) remains to be detailed, affecting implementation feasibility
  • Market dynamics: Pharmaceutical manufacturers may argue the policy doesn't address underlying drug pricing and could reduce incentives for insulin innovation, though price regulation advocates counter that other developed nations negotiate prices directly

Compiled from official sources — confirm details with the bill’s official record.

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