A group of Minnesota lawmakers shaping an emergency insulin program said Monday that they have reached a bipartisan agreement to get the medication to people in need. But an essential detail remains unsolved: How to pay for it.

Legislators and diabetes advocates seized on the work group's progress to renew calls for a special session, hoping to jump-start an insulin program before the Legislature reconvenes in early 2020. But there was little indication that a final deal among top political leaders is imminent — or even that funding was the sole source of disagreement.

The past Legislative session ended amid discord over how to finance the insulin plan. Many lawmakers left St. Paul frustrated by their failure to help diabetics who are struggling with dramatically increased insulin costs. Some members formed the working group, made up of Republicans and Democrats from the House and Senate, and started discussions to sort out their differences.

Sen. Matt Little, DFL-Lakeville, announced Monday that they have come to an agreement on how the program would work. Their plan would provide a 20-day supply to people who have a past or current insulin prescription and meet certain financial requirements. Some could get an additional two months' supply depending on their circumstances.

The emergency medications would be available at most pharmacies, and the state's Department of Human Services (DHS) would administer the program. The work group does not yet have a cost estimate for the program.

Meanwhile, Senate Majority Leader Paul Gazelka, R-Nisswa, said he is concerned about giving that responsibility to DHS — an agency that recently went through a major top-level management shake-up.

"I don't think it's wise to add emergency work to an agency with a temporary commissioner, a history of program fraud and failure, and a reportedly hostile work culture. We'll continue to work on solutions that have actual agreement, clear funding, are not easily abused, and lower the costs of prescription drugs for Minnesotans who need them," Gazelka said in a statement.

Gazelka's remarks contrasted sharply with the optimism expressed by Little and others in the working group.

"It's far from perfect, but this deal will save lives," Little said in a statement. "And every day we fail to act, another young person might die without emergency access to insulin. All we've got left is to hammer out the funding mechanism and we could pass this in a special session."

Democrats have previously proposed having insulin manufacturers pay a fee to cover program costs. Republicans suggested the state use money from its health care access fund.

There are also legislators who support some mix of the two funding sources.

With funding uncertain, two Senate Republicans on the working group warned that it is premature to say they have reached a deal. Sens. Scott Jensen and Jim Abeler, from Chaska and Anoka, said the working group has made real progress.

But they cautioned that the group needs the help of the three top state political leaders: Gov. Tim Walz, House Speaker Melissa Hortman and Gazelka.

Hortman and Walz, both Democrats, reiterated their view Monday that the pharmaceutical industry should bear some of the costs.

"As insulin prices skyrocket and pharmaceutical companies rake in profits, I am calling on Republicans to put the health and well-being of Minnesotans ahead of Big Pharma," Walz said. "I urge them to support this common-sense funding solution so that we can call a special session, pass this bill and provide much-needed relief to Minnesotans struggling to afford insulin."

Hortman, DFL-Brooklyn Park, said she is hopeful that in the coming weeks they will reach a funding agreement with Senate Republicans.

Meanwhile, diabetics and their family members who have fought for the emergency insulin program continued to urge lawmakers to act quickly.

"Every day that we delay taking action, Minnesotans who are struggling to afford insulin are at risk," diabetes patient advocate Quinn Nystrom said in a statement.

Jessie Van Berkel • 651-925-5044