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Bill proposes Minnesota join 19 states with co-pay caps for insulin

(The Center Square) – Two Minnesota DFL legislators announced a bill to cap state-regulated health plans’ co-pays for certain prescription drugs at $25 per month.

The bill Rep. Michael Howard, DFL-Richfield, and Sen. Erin Murphy, DFL-St. Paul, if passed, HF 3592, would apply the caps to drugs and medical supplies that treat severe allergic reactions and chronic conditions, such as diabetes and asthma. The bill would become effective in 2023.

Minnesota’s Alec Smith Insulin Affordability Act, which Gov. Tim Walz signed in 2020, provides individuals in urgent need of insulin a once-a-year opportunity to receive a 30-day supply of insulin for $35. In some cases, they can receive a second 30-day supply. Manufacturers must reimburse pharmacies for the insulin or replace it at no cost. The act also required manufacturers to provide insulin to eligible individuals in 90-day increments with a maximum co-pay of $50.

Alec’s mother, Nicole Smith-Holt supports the bill.

“Until there is federal legislation in place to cap the cost of prescription drugs, we need states to step in and create bills to make life saving medications affordable,” she said in the release. “I believe this bill will help many people in Minnesota afford their lives. Not only will it help make prescriptions more affordable but will also help type 1 diabetics afford the supplies needed to maintain a healthy life.”

As of September 2021, at least 19 U.S. states have a monthly co-pay cap for insulin, the National Conference of State Legislatures reports.

“We took leadership in passing Alec’s law and we’ve seen other states follow suit, but this issue of co-pay caps is one where Minnesota’s actually falling behind a little bit,” Howard told The Center Square in a phone interview Friday. “There’s red states and blue states, from Texas to Oklahoma to Kentucky that have put in co-pay caps, so it’s time for us to get with the program.”

He said HF 3592 is, in some ways, a method of addressing “unfinished business” of the Alec Smith Insulin Affordability Act in ensuring insulin is affordable for everyone.

HF 3592 would also cap costs on asthma inhalers and EpiPens. Glucose monitors and insulin pumps, which can cost patients several hundred dollars, would have caps of $50, a Minnesota Congressional news release said. Listed prices of the medications have risen dramatically in the past 10 years, it said.

He said the focus is on these supplies because they’ve heard the most concerns about their costs from their communities, but they are open to including other high-cost, essential supplies and medications. More than 400,000 Minnesotans have asthma and more than 500,000 have Type 1 or Type 2 diabetes, the release said.

He said he’s heard that the expenses are prompting people to choose less effective means to manage their diabetes. Ineffective management of diabetes sometimes leads to emergency room visits, he said.

There wouldn’t be much of a chance for Minnesota-based health plans since the co-pay cap is already at a reasonable rate, Howard said. Private insurers have voluntarily set co-pay caps for insulin that are the bill’s level, but those might be set annually, and they’re looking for a permanent cap, he said.

Howard said the bill would not apply to Employee Retirement Income Security Act (ERISA) plans, which are federally regulated, but it would address hundreds of thousands of Minnesotans.

A nationwide co-pay cap of $35 was included in a version of the Build Back Better Act that stalled in Congress, and there are discussions about introducing a standalone bill, Minnesota can’t wait for Congress to take action at the federal level, he said.

A similar bill, HF 2056, was proposed in Minnesota in 2021 and referred to the Health Finance and Policy Committee after being heard by the Commerce Finance and Policy Committee. The 2022 bill better addresses medical supplies but the co-pay section is not significantly different, Howard told The Center Square in a text Friday.

The bill has moved to the Commerce Finance and Policy Committee.


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