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Posts published in “Day: July 19, 2023”

The insulin key

You can imagine the anguish that people face every month – deciding whether to shell out $500 a month (or more) for insulin, or buying groceries … or making that rent payment.

Of course, members of Congress don’t face those choices with their top-grade insurance plans. And even without insurance, affordability for medications is not an issue for members of Congress. We don’t hear stories about senators or congressmen being homeless, or scrambling for medications needed to stay alive.

But the American Diabetes Association hears from a much different segment of the population – and those stories are gut-wrenching.

“One in four people with diabetes have reported rationing their insulin due to high costs,” said Stephen Habbe, vice president (state government affairs) with the ADA.

That’s scary. It doesn’t take a medical background to realize that bad things happen when diabetes patients ration insulin, or quit taking it entirely. Complications can ensue, such as heart attacks, strokes, kidney failure, or death. Yes, these are the kinds of stories that those with the American Diabetes Association hear every day. The thing is, there is no logical reason why insulin costs should be so outrageous. Insulin has been on the market for more than 100 years, and the ingredients have not changed dramatically – especially in recent decades.

“Although insulin was developed over 100 years ago, it’s still far too expensive and out of reach for many Americans living with diabetes,” Habbe said.

He’s right about that. So, it comes down to this. Insulin affordability is not an issue if you’re rich, have a top-grade private insurance plan, or on Medicare. Everyone else is out of luck.

President Trump – the political figure that many people love to hate – broke ground on the issue in a positive way, with ADA officials at his side. He created the Medicare Part D Senior Savings Pilot, which offered insulin at $35 under participating plans. But President Biden rescinded that and a string of other Trump executive orders, and eventually got around to calling for a $35 cap for everyone who needs it. However, that provision was kicked out of Biden’s landmark legislation, the Inflation Reduction Act, and Republicans – such as Idaho Sen. Mike Crapo – are not eager to bring it back.

Crapo, the ranking member of the Senate Finance Committee, has opposed capping insulin costs, saying that price fixing doesn’t work. He has proposed a GOP-based plan that, realistically, will go nowhere unless Republicans take control of the Senate and Crapo becomes the committee chairman. Crapo may be right about price fixing, but a system that allows costs for a life-saving drug to skyrocket, for no apparent reason, doesn’t work well either.

But the ADA, and states, are not waiting for the Washington politicians to act. According to Habbe, 24 states and Washington, D.C. have passed caps on state-regulated commercial health insurance plans. And the ADA is working to add more states to the list, including Idaho.

State Sen. Julie VanOrden of Pingree, who chairs the Senate Health and Welfare Committee, says she’s been studying the issue and is interested in seeing a bill. Her willingness to listen and learn about the issue doesn’t guarantee passage through the Idaho Legislature, but the odds become better for a fair committee hearing on the matter.

For Idaho lawmakers, who resist relying on the federal government, there’s an opportunity that might be too good to pass up. Idaho could do what the feds or Congress can’t do (or won’t do). As Habbe sees it, the statehouses are a good place to stage this battle.

“States served as laboratories of change, encouraging federal legislators to take this issue up, which ultimately led to the inclusion of the insulin cost-savings measures – including the $35 cap on insulin in Medicare in the Inflation Reduction Act,” he said. “We’ve seen bipartisan support for this legislation in states across the country and both the U.S. Senate and House have introduced bipartisan bills capping out-of-pocket costs for insulin.”

The issue is going to be kicked around more in statehouses and the halls of Congress. Politicians should keep in mind that those who depend on insulin don’t care what party gets credit for reducing the costs.

Chuck Malloy is a long-time Idaho journalist and columnist. He may be reached at ctmalloy@outlook.com