Date of Award

8-2026

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Economics

Committee Chair/Advisor

Devon Gorry

Committee Member

Reed Watson

Committee Member

Thomas Evans

Abstract

Insulin is a life-saving medication for people with diabetes that helps regulate blood glucose levels throughout the body. A Type 1 diabetic cannot survive without insulin, and a Type 2 diabetic’s quality of life greatly diminishes without access and use of this drug. Currently, many diabetics skip, ration, or abstain from insulin due to financial barriers. As of June 2026, 29 states have enacted insulin copayment caps for state-regulated commercial health insurance plans to reduce the financial burden of insulin costs. This study examines the impact of these caps on all commercially insured diabetics in the United States, particularly on overall insulin use and general health and medical care outcomes through a standard two-way fixed effects difference-in-differences model.

The results from the preferred specification indicate statistically significant findings on both overall insulin use and health and medical care outcomes for diabetics in states with these caps. Diabetics in capped states are 2.37 percentage points more likely to utilize insulin than diabetics in states without caps, holding all else constant. Additionally, poor mental health days (per month) decreased by approximately 20%, A1C checks increased by 15.5% (per year), and the probability of a routine checkup increased by 1.21 percentage points. Thus, the findings suggest that cost barriers currently suppress optimal levels of insulin use in states without caps and that the institution of these caps is associated with beneficial outcomes for insulin use, general health, and general medical care outcomes.

Author ORCID Identifier

0009-0003-4327-698X

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