Assembly Speaker Steve Yeager (D-Las Vegas) introduced a bill Thursday to cap the price of insulin drug copays to $35 a month for Nevadans on private insurance — a measure that could have major implications for the more than 1 in 10 Nevada adults with diabetes.

The measure, AB555, announced at a press conference in Carson City, comes as Yeager said some Nevadans are paying as much as $500 a month out of pocket for an essential substance discovered a century ago. It would place Nevada among the 26 states that have already set limits on the price of insulin for private payers — caps in other states range from $0 to $100 a month. 

The bill excludes Medicaid and Children's Health Insurance Program recipients, who typically receive insulin with no copay or, in some instances, a minimal copay. 

“This is critical, especially in a time when the federal government is talking about slashing health care coverage,” Yeager told The Nevada Independent in a Wednesday interview. “There's no reason insulin costs what it does … and this is an effort for us to be able to bring some relief to Nevadans who depend on insulin.”

Yeager said he brought the legislation after hearing from constituents who have faced untenable choices between affording medication and placing food on the table. Though those conversations surrounded all prescription drugs, insulin — a hormone that regulates blood sugar levels and that many people with diabetes need to take daily to survive — kept sticking out as a problem.

During a press conference Thursday, Christina Madison, a pharmacist, said the cost of insulin has been nothing short of devastating. She said every week, she talks to patients who are forced to ration insulin, taking less than prescribed, skipping doses or delaying refills because they can’t afford it. 

“I’ve watched people risk their lives not because they’re careless, but because they don’t have the financial means. Because the health care system has not been designed to deal with the crushing weight of all of the high costs of prescription drugs,” she said. “We are in the wealthiest country in the world. That should not happen.”

Rationing and other efforts by patients to cut down costs can lead patients to end up in the emergency room with diabetic complications, Madison said, adding that patients can also develop kidney failure, nerve damage and heart disease. In a worst-case scenario, she said they can die prematurely. 

She called the bill a “moral imperative.” She said it will also help address equity, ensuring that Black, Latino, Indigenous and low-income communities that are disproportionately affected by diabetes aren’t burdened by high drug costs. 

2023 data from the American Diabetes Association indicates that approximately 270,000 people in Nevada, or nearly 11 percent of the state’s adult population, have been diagnosed with diabetes. Yeager estimated that as many as 250,000 people living in the Silver State rely on the medication.

Part of the inspiration for the bill, Yeager said, also comes from former President Joe Biden’s Inflation Reduction Act, which capped the cost of insulin for Medicare recipients at $35 a month. 

Yeager said that the federal precedent, combined with the high need for the drug in Nevada, made insulin the clear choice for a cap, especially as costs are expected to remain high. 

Blue and red states alike have implemented similar caps, he said, adding that his bill builds on legislation from recent sessions, including a first-in-the-nation law requiring transparency on the pricing of diabetes drugs that former Gov. Brian Sandoval signed in 2017. 

Lawmakers in 2023 also sought to cap the costs for prescription drugs at the same level as federal Medicare-negotiated rates, but Gov. Joe Lombardo vetoed the bill. A similar measure, AB259, has returned this session.

Some Nevadans, Yeager said, can pay up to $6,000 annually for insulin with unpredictable price shifts. Those costs, he said, go directly into the pockets of insurance companies, drug manufacturers and pharmacy benefits managers that oversee the prescription drug benefits for health insurers.

Yeager pointed to the history of insulin and said its creators didn’t even intend for there to be high costs for the life-saving medication. In 1923, Frederick Banting, Charles Best and James Collip, who discovered and patented insulin, assigned patent rights for a symbolic $1 each to the University of Toronto. 

At the time, Banting famously said, “Insulin does not belong to me; it belongs to the world.” The university then licensed drug manufacturers to produce and sell the drug for a small royalty rate of 5 cents. Later that year, insulin was the highest-selling product in the pharmaceutical company Eli Lilly’s history.

A 2019 drug price transparency report from the state’s Department of Health and Human Services indicates that rising prescription drug prices lead to negative health and

financial burdens on the population. The report also showed that more than 60 percent of essential diabetes drugs experienced a "significant" price increase in the one or two years between 2017 and 2019. 

Barbara Hatzrell, a mom of a young daughter with diabetes, said during the press conference that insulin is not optional for her child. Without insulin, she said her daughter wouldn’t survive, and their family has had to choose between paying for groceries and medication.

“What price tag would you put on your child's life?” Hatzrell asked. “No parent should ever have to ask: Can we afford to keep our child alive this month? No one should go into debt just to manage a chronic condition. And no child should suffer just because the system puts profits over people.”

Though Yeager’s bill will likely receive pushback from health care industry groups such as insurers or pharmaceutical companies, he said Nevada is far from the first state to implement the cap and that other states with similar caps have not seen the health care industry pull out of the state or other catastrophes.

“I'm willing to listen to [opposition], but it has to be based in reason, in fact, and it can't be based in hyperbole,” Yeager said. “If I had a dollar for every time I've heard, ‘If you pass this bill, we're going to leave the state or go out of business,’ I wouldn't be uber-wealthy, but I would have several hundred dollars probably at this point in my legislative career.”

Yeager said he has not spoken with the governor or other legislative leaders about the proposal, but hopes that the cap will receive bipartisan support. As for its late introduction in the state’s 120-day legislative session, he said he wanted to wait until the bill was ready.

“If the decision for us as leaders, and that includes the governor, is, should we pad more profits to insurance companies, or should we try to bring relief to our constituents? I believe we're all in agreement that this is a time to be providing relief to Nevadans,” he said. “So I'm hopeful that we'll be able to get this through.”

A spokesperson for Gov. Joe Lombardo’s office said they had “no comment” on whether the governor would be open to signing the bill until the office receives it in its final form.

This story was updated at 11:22 a.m. on 5/8/25 to include comments made during the press conference and again at 11:52 p.m. to include the bill after it was introduced.