As outrage grows over the Minnesota Legislature’s failure to pass an emergency insulin bill, Gov. Tim Walz said this week that he does not have the executive authority to fix this reprehensible mistake on his own. If there is to be a solution in 2019, a special session is needed.
But there are no such limits on executive authority stopping others in the state — namely, the state’s private, nonprofit insurers and hospitals — from stepping up to temporarily ease the burden of paying for this vital but expensive diabetes treatment. Minnesota has long been fortunate to have civic-minded leaders at the helm of its medical centers and nonprofit insurers, which include Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica and UCare.
That community spirit is sorely needed to find stopgap solutions while lawmakers seek a longer-term fix.
This is an opportunity not only to do the right thing, but also to highlight the value of these organizations’ nonprofit status and the special tax treatment that comes with it. Nonprofits in Minnesota and elsewhere are exempt from many local, state and federal taxes. But with that comes the expectation that returns will be used to benefit the communities these organizations serve.
It’s time for the state’s nonprofit health care organizations to add a stopgap insulin program to their “community benefit” portfolios.
Insulin activists aren’t going away. Nor is a reversal of steady insulin price hikes likely anytime soon. The average cost of insulin therapy tripled between 2002 and 2012, according to GoodRx.com. The average price has risen 64% since 2014.
So what might a stopgap program look like? A Colorado reform offers inspiration. Lawmakers there recently capped out-of-pocket co-payments at $100 a month for those with insurance. Could Minnesota’s insurers voluntarily do something similar?
Could a fund with contributions from other nonprofits help offset the cost of doing this? Could insulin manufacturers and multistate pharmacy chains contribute as well?
Interim assistance is also needed for those without insurance, and one option is providing emergency insulin at an easily accessible location. The Minnesota Hospital Association raised concerns with an editorial writer about the cost and logistics of using hospital emergency rooms, and the point is well-taken.
It would be better to use pharmacies to dispense the drug and existing insurance information systems to track and approve its use. These are certainly not the only options, however. Leadership from Minnesota’s private-sector health care community should determine what else could be done and work out the finances.
A 2019 legislative analysis calculated the cost of the failed emergency insulin bill at $10 million a year. A program to fill in the gaps in the months until the Legislature can act would likely be less.
It is not unreasonable to ask industry to pick up this temporary cost, especially after state insurers’ strong financial performance last year. Their 2018 operating income was $500 million, up from $227.8 million the year before.
Working together with the state to launch a temporary insulin program would also generate favorable public relations and signal strongly that the private sector has health care solutions at a time when government is increasingly looked to for answers.