Measure would cap max copay Montanans pay for insulin
Elinor Smith
(UM Legislative News Service)
HELENA -- A bill proposed to the Senate Business Labor and Economic Affairs Committee would cap the maximum copay Montanans could pay for insulin at $35 for up to a 30-day supply of insulin.
Sen. Jason Small, R-Busby, sponsored Senate Bill 340.
“Twenty other states have passed a copay cost cap, and that's what we're trying to do here today. There's -- right now we're looking at setting the limit, the co-payment, or other cost sharing requirement to $35 for up to a 30 day supply of insulin,” Small said.
There were 17 proponents of the bill at a hearing Tuesday, ranging from medical professionals to people who have had to ration their insulin to be able to afford it.
Alison Sharkey-Hines has diabetes and when she got pregnant with her son, her tolerance to her insulin went up. She needed to take more and that was something she just couldn’t afford at the time. So she began rationing her insulin.
Sharkey-Hines’ son Kilian was born in October, 2020 and he died only two weeks later from complications of heterotaxy syndrome and hypoplastic left heart syndrome, which caused some of his organs to be missing and his heart to have irregularities on the left side.
“Had I just been able to afford my insulin, I would never have been through any of this and my son might still be here. If we capped the cost of insulin, ddiabetics wouldn't fear for their life. And children with stories like Kilian’s or other parents with stories like mine might not have these stories because maybe it would've been prevented,” Sharkey-Hines said.
Sharkey-Hines wasn’t the only one in the hearing who’d lost a loved one to complications related to diabetes, and other proponents spoke about how lack of access to insulin and insulin rationing contributed.
Research conducted by the Rand Corporation found that the average cost of all insulin in the United States in 2018 was $98.70, more than ten times the national average for all other researched countries combined.
According to Marci Butcher, the Montana Association of Diabetes Care and Education Specialist with the Department of Health and Human Services, one in four people who need insulin have to ration it. Her husband has diabetes, and she says the cost of insulin is a personal issue to her too.
“My husband has Type 1 diabetes, and when he was diagnosed with diabetes 30 years ago, his insulin cost $25. Today it's upwards of $300, and that's just not one vial a month. Many people need multiple vials a month, which results in thousands of dollars of out-of-pocket costs, and is such a burden to Montana families and can result in complications such as blindness and amputations and heart attacks, and strokes and kidney failure,” Butcher said.
There were no opponents of the bill and the committee did not take immediate action.
According to the American Diabetes Association, roughly 9.1% of the adult population of Montana has been diagnosed with diabetes. However, it’s estimated an additional 24,000 people in Montana are living with undiagnosed diabetes.
Those with diabetes in Montana have medical expenses that are 2.3 times higher than those without diabetes. In 2017 the total direct medical expenses to pay for the treatment of diabetes in Montana was $628 million dollars.
Similar federal legislation almost passed in 2022 under the Affordable Insulin Now Act, but died in the U.S. Senate. Twenty states and the District of Columbia have placed caps on insulin copayments.