Amid continuing friction between DFL and Republican lawmakers, key negotiators in the Minnesota Legislature said Tuesday that they have reached a tentative deal to create an emergency insulin program for diabetics who can't afford the lifesaving drug.
The agreement, set to be ratified when the Legislature convenes again next week, represents a breakthrough for behind-the-scenes talks that began soon after DFL-backed insulin legislation collapsed at the end of the 2019 session.
"We've got a deal," Sen. Scott Jensen, the top Republican negotiator on the issue, said Tuesday at the State Capitol. "Minnesota is going to lead in providing insulin to all people that are in need of insulin."
Under the draft agreement, diabetics who are within seven days of running out of insulin and unable to afford out-of-pocket prescription costs of $75 or more could obtain a 30-day supply at a pharmacy for a $35 copay. Insulin manufacturers would provide reimbursements or replace stockpiles that pharmacies distribute as part of the program.
The compromise represents a retreat for House DFL lawmakers who passed bills this year and last imposing fees on drug manufacturers to pay for the program. But lawmakers said drugmakers will still be held accountable under the deal, which instead imposes fines on companies that don't cooperate with the pharmacy program.
"This bill aims to make sure if someone is facing an emergency need for insulin they can get it immediately from a pharmacy," said DFL Rep. Michael Howard, the House lead on the issue.
Howard said members are still reviewing the draft language, released Tuesday morning. Still, the Richfield Democrat agreed that lawmakers are "on the cusp" of approving the landmark program.
"Until we have the signatures on the bottom line ... then we don't have a final deal," he said. "But I am confident we can obtain that."
The new deal follows months of public and private talks between DFL and Republican legislators in the two chambers. Jensen said that as lawmakers dispersed during the COVID-19 pandemic, he was instructed by legislative leaders to negotiate the agreement in calls of four people or fewer to avoid triggering open-meeting law requirements.
In addition to the emergency access program, the bill mandates that manufacturers provide longer-term assistance to patients who meet certain qualifications. Eligible Minnesotans making at or under 400% of the federal poverty level, roughly $51,000 for individuals or $69,000 for two-person households, could pay $50 for a 90-day supply.
Whether and how much manufacturers should pay for an emergency insulin program has long been a point of contention at the Capitol, where activists have been a vocal presence. A version of the plan passed by the DFL-controlled House earlier this year imposed $38 million in fees on drug manufacturers. The proposal that cleared the Senate did not.
Under the compromise, companies that do not participate in the program or comply with other reporting requirements would face fines of up to $3.6 million in the first year of enactment and $7.2 million the second year.
"We have some teeth in this bill," Howard said.
Drug manufacturers, which spent heavily to lobby on the issue, have raised concerns about previous versions of the proposal being duplicative of their existing programs and presenting constitutional issues.
But even as lawmakers rolled out the deal, tensions among the two sides remained high. Instead of a joint announcement with cosponsors and insulin advocates, Jensen called a solo news conference Tuesday to announce the agreement. He said the move reflected a disagreement over whether to hold a final public conference committee before signing off on the draft.
Still, Democrats showed up at Jensen's announcement, providing a statement of their own after he spoke.
A video released by Senate Republicans captured House Majority Leader Ryan Winkler, DFL-Golden Valley, flashing a middle finger at the camera as he stood several feet from Jensen at the microphone.
Winkler apologized in a tweet sent shortly after the Senate circulated the video.
"My son has Type 1 diabetes. It was poor form to express myself as I did, and for that I am sorry," he said. "But after months in which Senate Republicans blocked the emergency insulin bill, it was also poor form of them to claim credit alone after we are all on the edge of a deal."