State lawmakers will return to the Capitol Tuesday. If they care about having a healthy, productive session, they ought to heed an early diagnosis from one of their physician colleagues, Sen. Scott Jensen, R-Chaska.
An emergency insulin assistance bill needs to pass early in the session, Jensen said. This legislation, which would provide this lifesaving medication to diabetics who can't afford a new supply, got lost in last year's end-of-session chaos. Despite vows to pass it in a special session, and despite a flurry of offers exchanged in January between House DFLers and Senate Republicans, there was no special session and nothing has been enacted.
That's left insulin advocates rightly angry and energized. And it has influential advocates like Jensen and his colleague, Sen. Jim Abeler, R-Anoka, vowing to lead the charge on swift passage. With emotions running high, "right now this is sucking all the oxygen out of the room," Jensen said this week.
Jensen's right. The Legislature has a full agenda this session, but to get to these other issues, it's imperative that it first take care of this unfinished business. To its credit, the House DFL has already put together a well-crafted bill. Senate Republicans do not have a bill, and for timeliness reasons they ought to take up the House bill as a starting point. Opportunities to find common ground are plentiful.
That legislators need to be told to act swiftly is just shameful. Last spring, after the session failed to enact a bill, there was bipartisan agreement that no one should die from rationing insulin. Tragically, the death of a young Minnesotan made the need clear. In 2017, 26-year-old Alec Smith, a diabetic, died after rationing his medication. He didn't qualify for medical assistance programs but didn't make enough to afford insulin.
Both DFLers and Republicans have crafted proposals to help people like Alec. Key differences have been over eligibility, program copays, where patients would get insulin and how to pay program costs. Republicans have also wanted to sunset the program, while DFLers have pushed to include elderly Minnesotans on Medicare who struggle to pay for insulin.
The legislative priority should be on putting as few hurdles as possible between insulin and those who urgently need it; often these are Minnesotans without insurance or who have high-deductible insurance plans.
Including Medicare enrollees, who often can't use manufacturer assistance programs, is a must. Ensuring affordable copays is also imperative. The $75 copay for a 30-day supply in the GOP's Jan. 21 proposal is far too high.
The stickiest holdup in negotiations appears to be over funding the program, which does not yet have a cost estimate. Republicans' current proposal doesn't ask pharmaceutical manufacturers for enough aid and basically gives them credit for something they're already doing: patient assistance programs that are limited in duration or may be hard to access. A substantial registration fee on manufacturers as a condition of doing business here, a model pioneered by the state's opioid bill, would be sensible.
The state's insulin advocates certainly have the moral high ground in their demands for insulin makers to pick up the program's entire cost. If they want the bill passed quickly, however, a compromise is needed. It likely involves also using some of the state's provider tax revenue. Sharing the cost burden this way would take away a reason some Republicans vote no. Fairly or not, they see asking firms to foot the entire bill as a punishment.
The fund the provider tax flows into has a balance of $636 million. Dipping into it for a relatively small amount, an expected $1 million to $2 million, while expecting to raise a similar sum from drugmakers, is a reasonable way to make a deal and start saving lives.