ST. PAUL, Minn. — Leaders of the Republican majority in the Minnesota Senate said Thursday that they want to require drugmakers to provide free insulin to qualifying residents who can't afford the high cost of the life-saving medication.
They unveiled their plan a week ahead of when House Democrats plan to announce their own proposal. It'll be based on a bill they passed last year named after Alec Smith, a 26-year-old uninsured Minneapolis man who died in 2017 of diabetic complications because he was rationing his insulin. The clock ran out on the 2019 session in May before the two chambers could agree on the details, which resulted in political blowback against Republicans.
Since then, legislative leaders on both sides and Democratic Gov. Tim Walz have discussed the possibility of a special session on insulin this fall if they can reach a consensus first on the details.
"We recognize that Minnesotans are struggling to afford insulin, and I believe we have a plan here that will help fix that," said Sen. Eric Pratt, of Shakopee, who authored the bill. Supporting him at a news conference were Senate Majority Leader Paul Gazelka, of Nisswa, Senate Health and Human Services Committee chairwoman Michelle Benson, of Ham Lake, and Sen. Dan Hall, of Burnsville.
Under the Senate GOP plan, diabetics could qualify if they're not already on the Medicare, Medicaid or MinnesotaCare public programs, and their family income is less than 400% of the federal poverty line. Pratt said that means individuals making nearly $50,000 a year, and families of four making over $100,000, could qualify. And he said the program could be up and running by Jan. 1.
Patients would go to the web portal of the state-run MNsure health insurance exchange to obtain eligibility statements to bring to their doctors, who would then order patients 120-day refillable supplies from their preferred manufacturers. Patients would be eligible for one year before they would have to requalify. The state would require the manufacturers to provide the insulin without compensation as a condition for doing business in the state.
According to data from the nonpartisan Health Care Cost Institute, patients with Type 1 diabetes spent an average of $5,705 in 2016, nearly double what they paid in 2016. Pratt said he has not received estimates from Senate staff yet on how much the program will cost the state or how many people will be eligible. He acknowledged that the industry is not on board.
Benson said she plans to hold a hearing on the bill Monday. She supported the bill as "a really solid start" but indicated that changes are likely as interested people and groups weigh in.
"Governor Walz is encouraged to see both Democrats and Republicans in the Legislature working to address the lack of affordable insulin in Minnesota," said his spokesman, Teddy Tschann. He added that the governor is reviewing the proposal and looking forward to further discussions.
The Alec Smith Emergency Insulin Act, which was backed by the House Democratic majority last session, would have allowed diabetics who couldn't afford insulin to get 90-day emergency supplies. The money would have come from fees on manufacturers. Although language along those lines passed both chambers as part of a catch-all health and human services bill, a conference committee couldn't resolve the differences in time.
House Speaker Melissa Hortman, of Brooklyn Park, and the old bill's sponsor, Rep. Michael Howard, of Richfield, faulted the new Senate proposal for not specifically addressing the need for emergency insulin for patients in crisis.
But diabetes activist Quinn Nystrom, of Baxter, leader of the Minnesota chapter of #Insulin4all, said she was "thrilled" and "grateful" to see Senate Republicans coming to the table, adopting her group's hashtag for social media, and being willing to hold the insulin manufacturers accountable.
The Pharmaceutical Research and Manufacturers of America said the industry is already working to help patients with the costs of diabetes drugs, and faulted insurers for not passing along the price breaks they receive.
"Rather than creating a duplicative new state-run program, we believe efforts should be focused on fixing a broken system that's asking patients to pay a higher price for insulin than their insurance company," association spokesman Nick McGee said.