The ongoing battle over insulin prices in the U.S. was taken to the U.S. House of Representatives floor on Thursday. The Affordable Insulin Now Act, authored by three Democrats, passed the House by a vote of 232-193 and will now move on to vie for passage in the Senate.

The Affordable Insulin Now Act proposed a cap of $35 for a monthly insulin prescription. There is little information about how the price cap would work, apart from passing on much of the cost to employers and insurance companies. The progression of the act was eased by the arrival of twelve republican Representatives on the side of House Democrats.

The act must now confront its next challenge: making its way through the Senate before the legislative session ends. Democrats need ten Republican senators to back the proposal for it to pass. Democrats and Republicans agree that the chances of that happening are slim. 

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There is general agreement on the need for reform of the healthcare industry and the cost of prescriptions. However, finding a workable bipartisan approach has become a problem for Congress. The insulin cap was first proposed as part of President Joe Biden’s Build Back Better legislation, but the proposal was blocked by Democrat Joe Manchin because of its cost. 

Fighting among Democrats has blocked much of the Build Back Better legislation. Both sides of Congress have agreed that insulin is overpriced but have passed off the blame on the healthcare industry, faulting pharmaceutical companies and pharmacy benefit managers for the high cost of the drug.

Republicans in Congress pointed to the Affordable Insulin Now Act being authored by three Democrats involved in competitive Senate races as a sign of its failures. The bill was supported by Nancy Pelosi, who claimed it was a kitchen table issue for Americans. The House speaker explained that one in four American skips doses of insulin to ration their supply because of cost. 

The Affordable Insulin Now Act faces an uphill battle to become law and is en route to the Senate. Democrats Raphael Warnock and Jean Shaheen have teamed with Republican Susan Collins to bring the legislation to the Senate Floor. The legislation would seek ways of lowering the cost of insulin, a drug that — despite changing little since its discovery over a century ago — doubled in price between 2012 and 2016, per the Healthcare Cost Institute.