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Lawmakers updated on work to establish emergency insulin program

Nicole Smith-Holt, left, and Cindy Scherer Boyd testify before the House Health and Human Services Finance Division in support of a Rep. Michael Howard bill, right, that would establish an emergency insulin assistance account. Photo by Andrew VonBank

While there’s widespread agreement something must be done to lower the cost of insulin, which remains one of the Legislature’s most prominent and urgent issues, the debate over how to do so continued on Thursday.

The House Health and Human Services Finance Division held an informational hearing to discuss where those efforts currently stand and received updates on the work being done to address the problem.

Much of the discussion centered on a bill introduced during the 2019 legislative session.

Sponsored by Rep. Michael Howard (DFL-Richfield), HF485 would create an emergency assistance program to provide insulin to those who are unable to afford it and faced with shortages that put their lives in danger. It would require the state to begin the program by July 1, 2020 and charge drug manufacturers a fee to fund it. That language was passed by the House earlier this year, but not the Senate.

House Health and Human Services Finance Division 9/26/19

Howard said during Thursday’s hearing that new language has been drafted for the bill to include several important modifications that make “a strong bill even stronger.”

They include a new delivery mechanism that would allow patients to get insulin from a pharmacy the same day they seek it. Diabetics would bring a form attesting to their need for insulin to a pharmacy and would then be able to get a 30-day supply. Howard said it was “vitally important” that diabetics have same-day access to this “life-necessary” drug.

Other modifications include increasing eligibility guidelines for the program. The new language would provide insulin to individuals who earn up to 600% of the federal poverty level. The previous language would have capped eligibility at 400%. Another modification would attempt to connect Minnesotans to better long-term resources to manage future insulin concerns.

But Howard emphasized that the fee on manufacturers remains. “We think that’s very important,” he said, while noting that insulin prices have skyrocketed over the years. Howard said the fee would be “a sliver of a sliver” of the profits insulin manufacturers have made.

However, Rep. Jeremy Munson (R-Lake Crystal) said a fee on manufacturers was likely to increase the cost of insulin for everyone.

“I think it’s shortsighted to think they are not going to increase the cost on us,” Munson said.

He also questioned how much an assistance program could cost given there are 200,000 diabetics in Minnesota and said it could be a “$100 million program.”


Reasons for optimism?

Although significant differences still remain, especially how to pay for the program, there was some optimism that progress is being made on a solution. Howard credited a bipartisan working group that has been meeting throughout the summer and is making progress at bringing the two sides closer.

Senate Republicans recently announced a proposal that would provide insulin to individuals who earn up to 400% of the federal poverty level and are not eligible for state or federal assistance programs. Qualifying diabetics would receive the insulin through their doctors and remain eligible for the program for up to one year.

Howard said he agrees with some of what the Senate proposed, such as connecting diabetics in need of insulin with long-term resources. But he said the proposal does not address emergency situations when people are in desperate need of insulin.

Representatives of several insurance companies discussed changes they have made and are continuing to make so that the Minnesotans they insure would have no more than a $25 copay for a 30-day supply of insulin.

Rep. Tina Liebling (DFL-Rochester), the division chair, said she recognized additional tweaks may be needed to the bill but that the next step would be for the House and Senate to appoint lawmakers with the authority to make decisions to an unofficial conference committee. They would then work to develop agreed upon legislation that could be passed during a special session.  

“We’re hoping that can happen rather quickly,” Liebling said.

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