THE AMERICAN DIABETES ASSOCIATION APPLAUDS CALIFORNIA'S ACTION TO CAP COPAYMENTS FOR INSULIN ON STATE-REGULATED HEALTH PLANS

The following information was released by the American Diabetes Association (ADA):

This week, California became the 29th state to approve legislation capping the costs of insulin for Californians on private state-regulated health plans. The American Diabetes Association (ADA) applauds Governor Gavin Newsom's decision to sign Senate Bill 40, addressing insulin affordability by limiting cost-sharing for insulin to $35 for a 30-day supply.

In California, approximately 3.5 million adults have diagnosed diabetes. And while not all use insulin, those who do rely on it to survive.

"For far too long, many Americans with diabetes have made the difficult decision to ration this lifesaving medication to pay for other necessities, such as groceries or rent. This legislation will provide much-needed financial relief for people living with insulin-dependent diabetes," said Christine Fallabel, MPH, the ADA's state government affairs director. "The ADA and our community of Diabetes Advocates continue to push for legislation across the nation to make insulin accessible for all who need it to live."

Effective January 1, 2026, large group insurers will be required to cap insulin copayments at $35 for a 30-day supply and to ensure at least one insulin for a given drug type in all forms and concentrations be on the prescription drug formulary. Individual or small group health care insurers will need to cap copayments starting on January 1, 2027.

This makes Senate Bill 40 one of the strongest patient protection laws in the country for people living with diabetes.

The ADA thanks Senator Scott Wiener for authoring this important legislation and admires his commitment to insulin affordability for those who need it most.

"If we believe healthcare is a right as we should we have to make it affordable for everyone. This law ensures no family will be forced to choose between buying insulin and putting food on the table in California again," said Senator Wiener. "Working people are building the future of California, and we must make it affordable for them to live a healthy and thriving life here. I'm grateful that the Governor signed this bill into law, at a time when affordable healthcare is under attack across the country."

The estimated diabetes impact in California:

Adults diagnosed with diabetes: 3.5 million or 10.5% of the adult population

New diagnoses in adults every year: 231,000

Annual cost of diagnosed diabetes in California: $47.5 billion

Direct medical expenses for diagnosed diabetes: $34.1 billion in 2022

Indirect costs from lost productivity due to diabetes: $13.4 billion in 2022

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About the American Diabetes Association

The American Diabetes Association (ADA) is the nation's leading voluntary health organization fighting to end diabetes and helping people thrive. This year, the ADA celebrates 85 years of driving discovery and research to prevent, manage, treat, and ultimately cure diabetesand we're not stopping. There are 136 million Americans living with diabetes or prediabetes. Through advocacy, program development, and education, we're fighting for them all. To learn more or to get involved, visit us at diabetes.org or call 1-800-DIABETES (800-342-2383). Join us in the fight on Facebook (American Diabetes Association), Spanish Facebook (Asociacin Americana de la Diabetes), LinkedIn (American Diabetes Association), and Instagram (@AmDiabetesAssn). To learn more about how we are advocating for everyone affected by diabetes, visit us on X (@AmDiabetesAssn).

Contact Mimi Carmody for press-related questions.

[email protected] (703) 253-4957