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WASHINGTON — President Biden promised Monday that Democrats’ signature drug pricing plan will mean no insured American will spend more than $35 per month for insulin. Drug pricing advocates say that’s not good enough — they’re pushing for last-minute changes to expand those reforms to the uninsured.

Democrats’ drug pricing reforms, which are included in the larger spending package known as the Build Back Better Act, would cap how much those with insurance can pay out of pocket each month for insulin at $35. The provision currently applies to those covered by both Medicare and private insurance, but it does not change how much those without insurance will pay for their insulin.

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Drug pricing advocates say that’s a major misstep because those without insurance are most impacted by the drug’s sky-high sticker price, which can cost several hundred dollars per vial, depending on the manufacturer and formulation. They note, too, that several uninsured young people have died in recent years after they were forced to ration their insulin when they could not afford to pay for the drug.

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