The Minnesota legislature has kicked off its 2020 session this week with more debate around insulin affordability, a pressing issue legislators couldn’t resolve last session.
On Tuesday, the very first day of the session, the DFL-controlled House held a pair of hearings on insulin affordability. Some legislators say they want to fast-track a bill to fund an emergency program that would help anyone struggling to pay for their insulin.
By Thursday, insulin plans backed by the House and Senate leadership had already advanced through committee. Final approval will require bipartisan agreement, given Minnesota’s status as one of the only states in the country with a divided legislature.
The price of insulin has tripled over the last decade, and one in four diabetics reportedly ration their insulin due to its cost. That can lead to tragedy, as with the case of 26-year old Alec Smith, who died in 2017 while rationing his insulin.
Both the Republican-controlled Senate and DFL-controlled House passed versions of the bill, but couldn’t craft a compromise. The most significant hang-up seems to be that DFLers want pharmaceutical companies to pay for much of the cost, while Republicans don’t. Other differences between the Republican and DFL plans include eligibility, where patients would get insulin, whether or not to sunset the program and copays. Republican versions of the bill have included a $75 copay for 30 days of insulin.
During the summer, stakeholder hearings were held throughout the state in hopes of producing an improved bill with bipartisan support. In response, DFLers have introduced a bill they describe as a compromise, something Republicans have disputed.
Describing the Republican-led bill as “Minnesota-centric,” Sen. Rich Draheim, R-Madison Lake, said that the Republican approach would provide help for those who most need it, providing both emergency support and a long-term approach for diabetics like Smith, who made too much to qualify for medical assistance, but too little to afford his $1,300/ month insulin.
Le Sueur County’s Draheim, who sits on the Senate’s Health and Human Services committee, said the Republican proposal is continuing to change on a daily basis. He was critical of the DFL’s proposal, saying it’s too focused on “punishing” pharmaceutical companies and increasing the state’s revenue.
Under the DFL’s new proposal, most funding would still come from pharmaceutical companies. Senate Majority Leader Paul Gazelka, R-Nisswa, said he believes a compromise is “very close,” but described the DFL bill as a “grand program that moves us towards socialized medicine.”
The DFL’s effort has gotten the attention of pharmaceutical companies. On Thursday, the Pharmaceutical Research & Manufacturers of America sent a letter to lawmakers arguing that the DFL’s bill could violation of the U.S. Constitution.
Under the DFL bill, manufacturers would be required to provide emergency supplies of insulin to diabetics in need “at no charge,” without reimbursement. The group wrote that if pharmaceutical companies are not reimbursed for their product at market value, the state could be in violation of the 5th Amendment.
Sen. John Jasinski, R-Faribault, said that while he strongly supports ensuring that insulin is accessible to those who need it, he’ concerned that the DFL bill has become too expensive. Jasinski said he’s been pleased with the efforts of private insurers to keep insulin affordable.
Rice County’s only DFLer at the capitol, Rep. Todd Lippert, of Northfield, sees things differently. Lippert was critical of pharmaceutical companies for dramatically increasing insulin prices over the last several decades.
“We feel that as pharmaceutical companies are responsible for tripling the price of insulin, they should be reimbursing pharmacies for emergency supplies,” he argued.