Insulin Prescription Co-Pay Cap

Current understanding

Proposal to amend Michigan’s Insurance Code (1956 PA 218) by adding sec. 3406qq to cap the co-pay amount health insurers may charge insureds for prescription insulin. Follows a wave of similar insulin co-pay cap laws in other states. Affects insured patients using insulin (potential lower out-of-pocket cost) and health insurers (mandated cost-sharing limit).

Evidence log

• 2026-07-31 — Attorney General v Eli Lilly and Company: cross-connection with prescription-drug-pricing-mcpa: Both address consumer-facing insulin affordability — the copay cap regulates out-of-pocket costs while the MCPA action targets manufacturer list-pricing conduct. (novelty: 4)
• 2026-06-10 — Insurance: health insurers; coverage for prescription inhalers; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406xx.: cross-connection with inhaler-coverage-mandate: Companion drug-affordability mandates in the Insurance Code targeting specific prescription categories via sec. 3406-series additions. (novelty: 2)
• 2026-06-10 — Insurance: health insurers; cost-sharing for insulin coverage; eliminate. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406qq.: SB1033 (introduced) would add sec. 3406qq to 1956 PA 218 to eliminate cost-sharing for insulin coverage altogether — a stronger alternative to HB6101’s insulin co-pay cap approach that uses the same proposed section number. (novelty: 2)
• 2026-06-10 — Insurance: health insurers; coverage for epinephrine; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406ww.: cross-connection with epinephrine-coverage-mandate: Both are sec. 3406-series amendments to 1956 PA 218 mandating insurer treatment of specific life-critical medications (epinephrine coverage vs. insulin copay cap). (novelty: 2)
• 2026-06-17 — Insurance: health insurers; limit amount on co-pay for prescription insulin; provide for. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406qq.: cross-connection with insulin-pricing-consumer-protection: Two complementary Michigan insulin-affordability tracks: HB6101 caps insurer co-pays (insurance code), while the parallel AG insulin drug pricing report bill uses consumer protection law to surface pricing information. (novelty: 2)

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