Pilot program for providing affordable insulin to uninsured individuals

Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) is amended by adding at the end the following: 399V–8. Pilot program for providing affordable insulin to uninsured individuals (a) In general The Secretary shall conduct a 5-year pilot program under which the Secretary awards grants to 10 States for purposes of providing affordable insulin to uninsured individuals. (b) Awards The Secretary shall award grants under this section to 10 States that— (1) submit an application to the Secretary, at such time, in such manner, and containing such information as the Secretary may require; and (2) have high rates of uninsured individuals and individuals diagnosed with diabetes, which may include high rates of newly diagnosed diabetes. (c) Use of funds A State shall use the grant funds received under this section for any of the following purposes: (1) To assist in the purchase or dispensing of insulin, through Federally qualified health centers and retail community pharmacies, for uninsured individuals. (2) To enroll individuals in programs under which drug manufacturers provide financial or medication assistance to low-income individuals, in order to assist such individuals in obtaining insulin. (3) To allow Federally qualified health centers to establish new, or maintain or expand existing, on-site pharmacies owned and operated by the health center that provide low-cost insulin to patients, and to allow retail community pharmacies to provide low-cost insulin to patients. (4) To engage in other activities to assist uninsured individuals in obtaining insulin, as the Secretary determines appropriate. (d) Formula The Secretary shall establish a formula for purposes of determining the grant amount under this section for each State. Such formula shall— (1) provide for a minimum amount that will be provided to each State; and (2) take into account the rates of individuals with type 1 or type 2, insulin-dependent diabetes and of uninsured individuals in each State for purposes of determining any additional amounts provided to a State. (e) Accountability and Oversight A State receiving a grant under this section shall, not later than 1 year after receiving the grant, submit a report to the Secretary that includes— (1) a description of the purposes for which the grant funds received by the State were expended in the preceding fiscal year, and the activities of the State under the grant during such year; and (2) the number of individuals served through the grant. (f) Definitions In this section: (1) Affordable The term affordable, with respect to insulin, means that the out-of-pocket cost to the individual for the insulin is not more than $35 per 1-month supply. (2) Federally-qualified health center The term Federally-qualified health center has the meaning given such term in section 1905(l)(2) of the Social Security Act. (3) Insulin The term insulin means insulin that is licensed under subsection (a) or (k) of section 351 and continues to be marketed under such section. (4) Retail community pharmacy The term retail community pharmacy has the meaning given such term in section 1927(k)(10) of the Social Security Act. (5) Uninsured individual The term uninsured individual means an individual who— (A) is a citizen of the United States or a qualified alien (as defined in section 431(b) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996); (B) does not qualify for coverage under a Federal health care program (as defined in section 1128B(f) of the Social Security Act), the health program established under chapter 89 of title 5, United States Code, or a group health plan or group health insurance coverage (as defined in section 2791); and (C) is not entitled to a premium assistance tax credit under section 36B of the Internal Revenue Code of 1986. (g) Authorization of appropriations To carry out this section, there is authorized to be appropriated $100,000,000 for fiscal year 2027, to remain available until expended..