We were surprised to read the commentary “Let’s find a solution for the insulin crisis” (May 30) in which five Minnesota Republican senators expressed concern for the affordability of insulin and offered a new plan. We were surprised because we are Type 1 diabetes advocates who were at the Capitol all session working to pass the Alec Smith Emergency Insulin Act.

We never heard from these senators about their new plan. Each of them voted against Alec’s bill during a near party-line vote in the middle of the night during the special session.

The Alec Smith Emergency Insulin Act was crafted after more than a year of work, in close consultation with Alec’s parents, legislators, our Type 1 diabetes community and health care administrative and pharmacy experts. Contrary to the claims of some Republican senators, Alec’s bill is a well-vetted, workable solution that aims to ensure no Minnesotans ever again lose their lives because they cannot afford the insulin they need to survive. The bill was named after Nicole Smith-Holt’s 26-year-old son Alec, who died in 2017 from rationing insulin due to the high cost.

Here’s how the program would work. Low and middle-income Minnesotans who do not qualify for public programs would be eligible to receive a 90-day emergency supply of insulin at a significantly reduced cost. The program would use existing IT infrastructure and a basic enrollment process, making it simple and accessible for patients and pharmacists.

Alec’s bill would not be funded by taxpayer dollars. Instead, insulin manufacturers would be assessed a small fee. We feel strongly that it is only fair to ask insulin manufacturers to contribute to solving a crisis that they helped create. The price of this life-sustaining drug has tripled in the last decade. Meanwhile, the three giant insulin manufacturers who control the market have seen revenue and profits soar to unprecedented levels.

We welcome Republicans to join the discussion that has been happening for more than a year about how to ensure emergency access to affordable insulin. But the devil is in the details of the proposal they outline in their commentary. Unlike Alec’s bill, which is funded by a fee on drug companies, the Republicans wrote that their plan is to be funded by “citizens and civic groups donating to support the program,” and that “manufacturers and distributors would likely donate product and financial support.” If voluntary contributions do not cover the plan, then they suggest the state of Minnesota would pick up the rest.

The pharmaceutical industry and the insulin manufacturers — who rushed lobbyists to the Capitol once Alec’s bill began to gain momentum — would be overjoyed to be let off the hook in being required to use some of their exorbitant profits to help provide emergency supplies of insulin. But we think that’s wrong. It’s unacceptable to require Minnesota taxpayers to fund an emergency insulin program while giving the big drug companies a free pass.

The Minnesota Legislature should have passed Alec’s bill rather than killing it in the dark of night. If the Republican senators who played a role in derailing the bill are now sincere about creating an emergency insulin program they should reach out to the Type 1 diabetes community and the experts who helped craft Alec’s bill.

But before doing so they should know that our goal is to save lives while protecting the pocketbooks of Minnesota taxpayers, not protecting the interests of the big pharmaceutical companies.


Nicole Smith-Holt lives in Richfield. Lija Greenseid lives in St. Paul. Quinn Nystrom is from Baxter, Minn.