INS and kidney disorder: Recently, the president signed the Inflation Reduction Act of 2022, which institutes a $35 copay cap for insulin among Medicare beneficiaries.20,21 The copay cap does not have any effect on those with commercial insurance, the uninsured,22 or those receiving SGLT2 inhibitors or GLP-1 RAs, which are increasingly recommended as first line agents for patients with diabetes and preexisting cardiovascular or renal disease.