The first public meeting of a working group on insulin accessibility showed little progress Wednesday as Minnesota lawmakers remained at odds over how to operate and pay for an emergency program to help diabetics secure the lifesaving drug.

Republicans and Democrats, who have been meeting over the past two months, both want patients who are having a crisis to immediately get insulin they can afford. They also want to connect people with long-term health care coverage to prevent future emergencies for those dealing with the skyrocketing cost of insulin.

But shortly after legislators kicked off the meeting of their insulin assistance working group, lingering divisions were quickly evident.

"We've been talking past each other for months now," Sen. Michelle Benson, R-Ham Lake, said as the two sides diverged over the logistics of how to dispense emergency supplies of the drug.

The meeting was called by House Speaker Melissa Hortman, DFL-Brooklyn Park, who asked for a 60-day update from the lawmakers. The bipartisan group was tasked with smoothing out differences that left lawmakers at loggerheads at the end of the last legislative session in May.

Since then, legislators have repeatedly said they believe they can wrap up a plan and pass it in a special session before the Legislature reconvenes Feb. 11.

Hortman said Wednesday that she doesn't see that happening. But she hopes Democrats, who have the majority in the House, and Republicans, who control the Senate, can reach a deal before the next session starts.

"It's hard to imagine a special session at this point. But it would be great to have something that we could enact in the first week," she said.

The major sticking point remains whether drug manufacturers will fund the program through a fee, as Democrats prefer, or if they will supply free insulin as Republicans proposed. However, much of Wednesday's discussion was focused on the operating details.

House Democrats want to contract with a pharmacy benefit manager — the middleman in the pharmaceutical supply chain — to work with pharmacists who would be responsible for giving out the emergency medication. Sen. Eric Pratt, R-Prior Lake, said that would cost more and take longer to get started. Republicans argue doctors and hospitals should have a role in supplying drugs.

Until Wednesday, the working group's discussions had happened outside the public eye.

In their first open meeting in a Capitol hearing room, diabetes advocates were listening closely.

"I'm having a little déjà vu," said Alexis Stanley, a diabetic who first attended a meeting with legislators about the high cost of insulin last year. "A whole year has passed since then, and now I'm one year closer to having to face my biggest fear and nothing has really gotten done."

The 20-year-old college student said she is worried about affording her medication after she goes off her parents' insurance at age 26. In the two months that the work group has been meeting, she said the retail price of the insulin she needs totaled $2,435.

Jessie Van Berkel • 651-925-5044