FY2026-2035 · CBO February 2026 baseline

Universal Insulin Cap

$35/month insulin cap for Medicare and private insurance. A cost-sharing cap shifts liability onto plans, so CBO scores it as adding ~$11B to the deficit over 10 years. **Illustrative**: an unfitted reconstruction a long way from its published figure, shown for the shape of the policy rather than as an estimate of it.

Ten-year deficit effect, conventional+$7.0Badds to the deficit
With macroeconomic feedback and debt service+$7.8BFRB/US-Lite (Federal Reserve calibrated)
Checked against

Published score +$11.4B; this estimate is 39.0% away (unfitted reconstruction). Unfitted reconstruction, 39.0% from $11B (Congressional Budget Office) — no constant is fitted to this figure.

No out-of-sample band: no pre-registered row scores a drug-pricing reform. The 44 pre-registered Tier 1 rows are the only tier that measures this model's accuracy, and none of them scores a policy of this kind.

Year by year

billions, conventional
Fiscal yearRevenueDeficit, conventionalMacro feedbackDebt serviceDeficit, dynamic
2026$0.0B+$0.7B+$0.1B+$0.0B+$0.6B
2027$0.0B+$0.7B+$0.1B+$0.1B+$0.6B
2028$0.0B+$0.7B+$0.1B+$0.1B+$0.7B
2029$0.0B+$0.7B+$0.1B+$0.1B+$0.7B
2030$0.0B+$0.7B+$0.1B+$0.1B+$0.8B
2031$0.0B+$0.7B+$0.0B+$0.2B+$0.8B
2032$0.0B+$0.7B+$0.0B+$0.2B+$0.9B
2033$0.0B+$0.7B+$0.0B+$0.2B+$0.9B
2034$0.0B+$0.7B+$0.0B+$0.3B+$0.9B
2035$0.0B+$0.7B+$0.0B+$0.3B+$1.0B

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Who pays

first year, by income group

This is a spending or sector policy, so there is no tax table by income group.

Economic effects

difference from the CBO baseline
GDP, summed over the window+0.01percent-years
Jobs at the largest effect+1K
Deficit effect of the GDP change-$0.7Bmore tax collected
Deficit effect of interest on the debt+$1.5Bmore debt, more interest
Fiscal yearGDP levelJobsUnemployment10-year rateGDP change, deficitInterest, deficit
2026+0.002%+1K-0.00 pt+0.00 pt-$0.1B+$0.0B
2027+0.002%+1K-0.00 pt+0.00 pt-$0.1B+$0.1B
2028+0.002%+1K-0.00 pt+0.00 pt-$0.1B+$0.1B
2029+0.001%+1K-0.00 pt+0.00 pt-$0.1B+$0.1B
2030+0.001%+1K-0.00 pt+0.00 pt-$0.1B+$0.1B
2031+0.001%+0K-0.00 pt+0.00 pt-$0.0B+$0.2B
2032+0.000%+0K-0.00 pt+0.00 pt-$0.0B+$0.2B
2033+0.000%+0K-0.00 pt+0.00 pt-$0.0B+$0.2B
2034+0.000%+0K-0.00 pt+0.00 pt-$0.0B+$0.3B
2035+0.000%+0K-0.00 pt+0.00 pt-$0.0B+$0.3B

FRB/US-Lite (Federal Reserve calibrated). Demand effects fade over five to seven years as monetary policy responds; there is no supply-side channel. The dynamic score is the conventional score, plus the deficit effects of the GDP change and of interest on the debt: +$7.0B - $0.7B + $1.5B = +$7.8B.

Other scoring models

exploratory
ModelTen-year deficit effectMethod
CBO-Style+$7.0BStatic + ETI behavioral response + optional FRB/US dynamic feedback
TPC-Microsim PilotCannot score thisUniversal Insulin Cap ($35) (DrugPricingPolicy) does not map onto current microsim pilot reforms (income-tax rates, CTC, EITC, SALT, std deduction, AMT exemption).

No pilot model returned distributional output; the comparison is aggregate-only.

CBO-Style is the model behind the headline above. The TPC-style microsimulation is a pilot: where the two disagree, the gap tells you how much the answer depends on method. It is not an official range.

Limitations

Cite asWilse-Samson, Laurence. “Universal Insulin Cap.” Fiscal Policy Calculator, CBO February 2026 baseline, FY2026-2035. https://fiscal.lwilsesamson.com/explore/insulin-cap-universal