Democrats fail to overrule parliamentarian on insulin price cap as GOP votes no

Senate Democrats fell short of an effort Sunday to overrule a decision by the parliamentarian that effectively struck down a proposal sponsored by Sen. Raphael Warnock (D-Ga.) to cap out-of-pocket insulin costs at $35 a month for people not covered by Medicare.  

Sen. Lindsey Graham (R-S.C.), the ranking member of the Budget Committee, sought to enforce the parliamentarian’s ruling that Warnock’s cap on insulin prices violated the Byrd Rule because it would set prices in the commercial market and therefore couldn’t pass with a simple majority vote.  

Senate Democrats insisted on a vote to waive the procedural objection to put Republican senators on record, including Sen. Ron Johnson (R-Wis.), the most vulnerable member of the GOP conference, on the record as opposing a popular proposal to rein in insulin prices.  

The Senate voted 57-43 to waive the procedural objection against the insulin price cap but Democrats scored a symbolic victory when seven Republicans voted with the Democrats: Sens. Bill Cassidy (R-La.), Susan Collins (R-Maine), Josh Hawley (R-Mo.), Cindy Hyde-Smith (R-Miss.), John Kennedy (R-La.), Lisa Murkowski (R-Alaska) and Dan Sullivan (R-Alaska). 

“We’re going to force them to vote no and put them on the record,” said one Democratic senator before the vote, explaining the political strategy ahead of a vote lawmakers knew ahead of time was going to fail.  

All 43 “no” votes came from Republicans. 

The vote was unusual as the majority party rarely insists on a vote to overrule the parliamentarian’s decision on whether a legislative proposal is protected by the special budgetary rules that allow it to pass with a simple-majority vote.  

Senate Health Committee Chairwoman Patty Murray (D-Wash.) said colleagues who voted to override the parliamentarian would allow “people to get insulin at $35 a month.” 

“Thirty-seven million people in our country have diabetes, and it’s absolutely wrong that many of them cannot afford the insulin they need to live,” she said. “I’ve heard from people in my state who risk their life and ration insulin to make ends meet, all the while drug companies are jacking up prices.”

“The cost of insulin has tripled over the last decade,” she said.  

Democrats won a partial victory, however, because the parliamentarian allowed Warnock’s $35 insulin cap to apply to Medicare beneficiaries, which could influence prices in the private market.  

A Democratic aide called the cap on insulin for people covered by Medicare “a big deal.”  

The aide noted that 1 in every 3 Medicare beneficiaries have diabetes and more than 3.3 million Medicare beneficiaries use common forms of insulin, according to the Centers for Medicare and Medicaid Services.  

Senate Minority Whip John Thune (R-S.D) told reporters on Sunday morning that Democrats knew well before the vote that the parliamentarian ruled a cap on insulin prices in the private market a violation of Senate rules.  

“She knocked it out.  They added it back in and basically, you know, wanted to tempt us to, I guess, vote against it,” Thune said, while taking aim at Democrats for “overruling the parliamentarian.” 

He said the effort to overturn the parliamentarian undermined the integrity of Senate procedure and Senate rules.  

“It undermines the whole reconciliation process if you if you start doing that,” he said. “So, I mean, I think there’s a right way and wrong way to do it. They want to get that vote, there’s a lot of ways they can get that vote, but doing it this way, was the wrong way to do it.” 

Warnock pushed back on Thune’s remarks, telling The Hill ahead of the vote that the blame would fall on Republicans if a major portion of the insulin cap fell out of the bill.  

“The parliamentarians’ rules are not self-enforced,” Warnock said. “So, only when we don’t do what 20 other states have already done, many of them red states, is if folks here decide to put politics in front of the people.” 

“We can get this done and if it doesn’t get done, it’s on them,” he said. 

The vote on Sunday comes a day after another provision was struck from the bill that sought to lower drug prices by targeting drug companies with price increases that outpaced the rate of inflation.