St. Paul may be divided politically, but it’s united behind the need to help Minnesota diabetics who can’t afford their life-saving insulin.
And if Nicole Smith-Holt can be optimistic that differences will be worked out between bills in the DFL-controlled House and Republican Senate, leading to the creation of a statewide emergency insulin program, then all Minnesotans can be hopeful. It was Smith-Holt’s son Alec Smith’s tragic death in 2017 that drew attention to the difficulties far too many diabetics have covering the skyrocketing cost of their prescriptions. Alec Smith had turned 26, had to leave his parents’ insurance plan, and was attempting to ration what insulin he could afford when he fell into a diabetic coma alone in his apartment.
“There’s definitely room for compromise,” Smith-Holt said in an interview this week with the Duluth News Tribune about legislation that literally would mean life and death. Despite that urgency, a similar measure failed during last year’s legislative session.
“I feel very optimistic this time,” Smith-Holt said. “I think that both sides learned a lot from last session. I think the public has really spoken out. And I think all of our legislators learned a lot by listening to their constituents. And their constituents want this completed.”
Before it can be, a compromise needs to be found on at least four sticking points. Encouragingly, the two sides don’t seem too far apart on any of them.
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Tne, the Senate bill includes a $75 copay and the House bill a $30 copay. Obviously, a lower copay is more affordable, especially when those paying are likely to be “uninsured or underinsured” and “not having steady income,” as Smith-Holt stated it.
Two, the Senate bill limits participation in the emergency program to 30 days while the House bill says 90 days. “Thirty days is unrealistic for somebody to get their life together, to ensure that they’re not going to be facing another emergency,” Smith-Holt said. “We feel like 90 days is the better timeframe for people to kind of get themselves into an insurance program … or to get themselves into a job and allow time for their benefits to kick in. … That 30 days is not a lot of leeway.”
The third sticking point is the question of who will pay for the program and the insulin to be given out to those in an emergency. While insulin manufacturers can’t be forced to pony up and can convincingly argue that attempting to do so would violate a constitutional right, and while manufacturers already have emergency-help programs via free clinics and elsewhere, “We just hope that they would agree to be part of the solution here because Minnesotans are dying,” Steve Kinsella, a communications professional in the Twin Cities whose son is a type 1 diabetic and who’s helping to push the legislation, told the Opinion page. “I hope that whatever we land on, the insulin manufacturers are part of (it).”
A fourth sticking point is the penalty insulin manufacturers would face if they don’t comply with whatever Minnesota lands on. The House bill doesn’t include a penalty, and the Senate’s $100,000 a year for noncompliance isn’t steep enough in Smith-Holt’s estimation. “That really is just a drop in the bucket for Big Pharma,” she said. “There’s no incentive for these companies to participate if they’re only being fined $100,000 a year.” She suggested $100,000 a month, at least, with fines doubling after three months.
Final legislation no doubt can be found somewhere in the middle of these and other differences. The Senate is expected to pass its bill this week, sending it to a conference committee where differences in the two bills can be worked out and a single bill produced.
“I think there’s a way to get there,” Kinsella said. “Things are moving in a positive direction.”
They seemed to be last year, too — until they weren’t. Lawmakers from both sides of the aisle can embrace the optimism this time to produce an emergency insulin program — helping to put an end to diabetics in Minnesota needlessly and tragically dying.
This editorial is the opinion of the Duluth News Tribune's editorial board.
