To provide for discounted insulin for low- and middle-income Americans.

SA 5385. Mr. KENNEDY submitted an amendment intended to be proposed
to amendment SA 5194 proposed by Mr. Schumer to the bill H.R. 5376, to
provide for reconciliation pursuant to title II of S. Con. Res. 14;
which was ordered to lie on the table; as follows:

At the appropriate place, insert the following:

SEC. ___. PROVIDING DISCOUNTED INSULIN TO LOW- AND MIDDLE-
INCOME AMERICANS.

(a) In General.--There is appropriated to the Secretary of
Health and Human Services (referred to in this section as the
``Secretary''), out of any monies in the Treasury not
otherwise appropriated, $3,100,000,000 for fiscal year 2023,
to remain available through September 30, 2026, for making
payments to Federally-qualified health centers for purposes
of covering direct costs incurred by such centers for making
discounted insulin and epinephrine available to qualifying
center patients, as described in subsection (b).
(b) Insulin and Epinephrine Affordability.--
(1) In general.--If a Federally-qualified health center
participates in the drug discount program under section 340B
of the Public Health Service Act (42 U.S.C. 256b) and makes
insulin or injectable epinephrine available to its patients,
such center shall provide insulin and injectable epinephrine
at or below the discounted price paid by the center or
subgrantee of the center under the drug discount program
under such section 340B (plus a minimal administration fee)
to qualifying center patients through fiscal year 2026.
(2) Limitation.--As applicable, the cost of insulin and
injectable epinephrine made available to patients pursuant to
this subsection shall not exceed the cost of such insulin and
injectable epinephrine pursuant to the schedule of fees or
payment under section 330(k)(3)(G) of the Public Health
Service Act (42 U.S.C. 254b(k)(3)(G)).
(c) Payments.--The Secretary shall make prospective
quarterly payments to Federally-qualified health centers in
an amount that equals the sum of the following:
(1) The product of--
(A) the number of units of insulin furnished to qualifying
center patients in the previous quarter; and
(B) the direct costs of procuring and making available each
such unit of insulin at the discounted rate provided for
under this section.
(2) The product of--
(A) the number of units of injectable epinephrine furnished
to qualifying center patients in the previous quarter; and
(B) the direct costs of procuring and making available each
such unit of injectable epinephrine at the discounted rate
provided for under this section.
(d) Use of Payments.--Payments made to Federally-qualified
health centers under this section shall be used for the sole
purpose of covering direct costs incurred by such centers in
making insulin and injectable epinephrine available to
qualifying center patients under subsection (b).
(e) Definitions.--In this section:
(1) Federally-qualified health center.--The term
``Federally-qualified health center'' has the meaning given
such term in section 1905(l)(2)(B) of the Social Security Act
(42 U.S.C. 1396d(l)(2)(B)).
(2) Qualifying center patient.--The term ``qualifying
center patient'' means a patient of a Federally-qualified
health center whose household income is equal to or less than
350 percent of the Federal poverty line and who--
(A) has a cost-sharing requirement under a health insurance
plan for insulin or injectable epinephrine under which the
patient out-of-pocket share is more than 20 percent of the
total amount charged by the center for insulin or
epinephrine;
(B) has a high unmet deductible under a health insurance
plan; or
(C) has no health insurance.
(f) Prevention and Public Health Fund Offset.--Section
4002(b) of the Patient Protection and Affordable Care Act (42
U.S.C. 300u-11) is amended--
(1) in paragraph (6), by striking ``each of fiscal years
2022 and 2023'' and inserting ``fiscal year 2022'';
(2) by striking paragraphs (7) and (8);
(3) by redesignating paragraph (9) as paragraph (8); and
(4) by inserting after paragraph (6) the following:
``(7) for fiscal year 2027, $1,800,000,000; and''.
______