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Key Takeaway
Blackburn voted against the Inflation Reduction Act’s provision to cap insulin costs at $35/month for Medicare recipients — a provision that directly benefits thousands of diabetic seniors across East Tennessee.
The $1.4 Billion in IRA Savings Tennessee Seniors Stand to Gain
Despite Blackburn’s opposition, the Inflation Reduction Act is delivering significant benefits to Tennessee. The $35 monthly cap on Medicare insulin copays took effect in January 2023, immediately saving thousands of Tennessee seniors hundreds of dollars per year on a medication many of them cannot live without. Medicare drug price negotiation began with the first 10 drugs in 2024, with prices taking effect in 2026 — several of which are commonly prescribed to Tennessee’s Medicare population.
On the energy side, IRA tax credits for residential solar, heat pumps, and energy-efficient home improvements are available to Tennessee homeowners. Electric vehicle tax credits benefit both consumers buying EVs and the growing automotive manufacturing sector in Tennessee, which includes major EV production facilities. The IRA’s clean energy manufacturing incentives have attracted billions in private investment to the Southeast, including Tennessee.
PhRMA Donations and Blackburn Campaign Contributions
Blackburn’s opposition to the IRA’s drug pricing provisions aligns with her longstanding relationship with the pharmaceutical industry. OpenSecrets data shows that pharmaceutical manufacturers and their PACs have been consistent donors to Blackburn throughout her career. Her vote against Medicare drug price negotiation — a policy supported by roughly 80% of Americans in polling, including strong majorities of Republicans — is one of the clearest examples of her prioritizing industry interests over constituent needs.
The Governor’s Role in Healthcare Costs
Tennessee’s governor plays a significant role in healthcare policy through oversight of TennCare, regulation of the state insurance market, and advocacy for or against federal healthcare programs. A governor who voted against capping insulin at $35 and against allowing Medicare to negotiate drug prices may not be the strongest advocate for reducing healthcare costs for Tennessee families — particularly in rural areas where healthcare access is already limited and costs disproportionately burden working families.
Blackburn Opposed the Inflation Reduction Act, Blocking Medicare Drug Savings for Tennessee Seniors
In August 2022, Senator Marsha Blackburn voted against the Inflation Reduction Act (IRA), landmark legislation that—among other provisions—capped Medicare insulin costs at $35 per month, allowed Medicare to negotiate prescription drug prices for the first time, capped out-of-pocket drug spending for Medicare beneficiaries at $2,000 per year, and invested in clean energy and climate programs. Every Senate Republican, including Blackburn, voted no.
What a $35 Insulin Cap Means for Diabetic Patients in the Tri-Cities
Tennessee has one of the highest diabetes rates in the nation, and the 1st Congressional District is no exception. Many Medicare beneficiaries in East Tennessee were paying hundreds of dollars per month for insulin before the IRA’s price cap took effect. The $35 monthly cap has been a direct, measurable improvement in the lives of thousands of seniors and disabled residents across the region—a benefit that exists despite Blackburn’s vote, not because of it.
How Medicare Can Now Negotiate Prices on 10 High-Cost Drugs
For the first time in history, the IRA authorized Medicare to directly negotiate prices on high-cost prescription drugs. The first round of negotiations targeted 10 of the most expensive drugs, including treatments for blood clots, heart failure, and diabetes. For Medicare enrollees in Tennessee—many of whom live on fixed incomes—these negotiations mean real savings that help them afford the medications they need to stay alive and healthy.
The $2,000 Annual Cap on Medicare Drug Spending
Before the IRA, there was no annual limit on out-of-pocket drug spending under Medicare Part D. Some beneficiaries with cancer, rare diseases, or multiple chronic conditions faced costs exceeding $10,000 per year for medications alone. The IRA’s $2,000 annual cap provides financial protection that is particularly meaningful for residents of East Tennessee, where median household incomes are below the national average and catastrophic drug costs can mean choosing between medication and groceries.
IRA Clean Energy Tax Credits Coming to Tennessee
The IRA also included the largest clean energy investment in American history, with tax credits for solar, wind, electric vehicles, and energy efficiency that benefit Tennessee manufacturers and consumers alike. For TVA-served communities in East Tennessee, these investments support the transition to cleaner energy while creating jobs in manufacturing and installation.
Monthly Savings for Medicare Enrollees Across East Tennessee
Tennessee has one of the highest rates of diabetes in the country, with approximately 14% of adults diagnosed with the condition. For Medicare recipients who depend on insulin, the $35 monthly cap enacted by the Inflation Reduction Act has been a life-changing policy. Before the cap, some seniors were paying hundreds of dollars per month for insulin — forcing impossible choices between medication, food, and other necessities.
In East Tennessee specifically, the combination of higher-than-average diabetes rates and lower-than-average incomes made the insulin cost burden particularly severe. Blackburn’s vote against the IRA was effectively a vote against this relief for her own constituents. While she has stated her general support for lower drug prices, her vote against the legislation that actually delivered those savings contradicts that position.
How Medicare Can Now Negotiate Prices on 10 High-Cost Drugs: A Historic Shift
The Inflation Reduction Act also gave Medicare the authority to negotiate drug prices directly with pharmaceutical companies for the first time — a policy change that had been debated for decades. Prior to this law, Medicare was prohibited from negotiating, meaning taxpayers and Medicare recipients paid whatever price the pharmaceutical companies set.
The first round of Medicare drug price negotiations targeted ten of the most expensive medications, including treatments for heart disease, blood clots, and diabetes. The negotiated prices are expected to save Medicare billions of dollars and reduce out-of-pocket costs for millions of seniors. Blackburn’s opposition to giving Medicare this negotiating power aligned her with the pharmaceutical industry’s position against price negotiations — an industry that has been among her largest campaign contributors.
Solar and EV Manufacturing Jobs Created by IRA Incentives
Beyond healthcare provisions, the IRA also included the largest clean energy investment in American history, directing hundreds of billions of dollars toward renewable energy, electric vehicles, and energy efficiency. Tennessee has attracted significant clean energy investment, including electric vehicle manufacturing facilities. The IRA’s tax credits and incentives have helped make these investments economically viable — investments that are creating thousands of jobs across the state.
The Tennessee Valley Authority, which provides electricity to much of East Tennessee, has been transitioning its energy portfolio toward cleaner sources. The IRA supports this transition through investments in solar, wind, and battery storage technology. As governor, Blackburn would work closely with TVA and state energy policy — her opposition to clean energy investment raises questions about how she would approach Tennessee’s energy future.
Related: See also Blackburn’s 70+ votes to repeal the ACA and her initial opposition to the PACT Act for veterans.
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Frequently Asked Questions
Did Blackburn vote against capping insulin at $35?
Yes. Blackburn voted No on the Inflation Reduction Act, which capped Medicare insulin copays at $35 per month and enabled Medicare to negotiate prescription drug prices for the first time.
How does the IRA affect Tennessee seniors?
Tennessee has a large Medicare-eligible population, particularly in rural East Tennessee. The $35 insulin cap and drug price negotiation provisions directly benefit seniors who previously paid hundreds per month for insulin and other critical medications.
What clean energy benefits did Blackburn vote against?
The IRA includes tax credits for solar, wind, electric vehicles, and energy efficiency upgrades. Tennessee manufacturers and rural homeowners benefit from these incentives, which Blackburn opposed.
Sources
- Senate Roll Call Vote: Inflation Reduction Act
- CMS: Inflation Reduction Act and Medicare
- KFF: IRA Prescription Drug Provisions Impact
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