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Bill would cap insulin cost at $100 per 30-day supply

Bill would cap insulin cost at $100 per 30-day supply

 LINCOLN–In 1996, a vial of insulin cost $21. Today, that same exact vile is worth over $300, said Christine Fallabel from the American Diabetes Association at a hearing regarding the price of insulin Feb. 18.

Although the chemical formulary for insulin has not changed in over two decades, the price of insulin continues to rise causing a number of different complications for people with diabetes.

To facilitate people’s access to the life-saving medication, two bills were introduced by Sen. Kate Bolz of Lincoln and Sen. Justin Wayne of Omaha. Under LB 949 and 970, the co-payment cost of insulin after insurance would be capped at $100 for a 30-day supply, regardless of the amount or type of insulin a person needs.

“This bill is part of a national conversation to protect people from predatory pricing,” Wayne said. “Since healthcare companies and insurance companies are doing it, I believe the state must act.”

Although the bills are nearly identical, they have a key difference.

In order to ensure the impact of the cap does not have any negative impact on Nebraska providers, LB949 includes a provision to protect insurance premiums. Based on the analysis, Bolz said there should not be a negative impact on providers but the bill still has that safety net.

“People with diabetes are sometimes often forced to choose between insulin and rent or insulin and food to survive,” Fallabel said. “For a chronic auto-immune disease that is not preventable and has no cure, that seems unnecessarily excessive and dangerous.”

Fallabel has lived with Type 1 diabetes for 20 years and said the average diabetic goes through two to eight vials of insulin a month.

“Even if you have a health insurance plan, some people end up paying thousands of dollars per month simply to live,” she said. “Or they’re rationing their medicine, which quickly leads to complications and even death.”

According to Fallabel, high-deductible health plans have increased from 10% in 2007 to up to 25% in 2017. These high-deductible health plans offer a way for people to have some sort of coverage that costs less per month, but they have a higher bar to reach for full coverage medicines like insulin.

Jay McLaren, vice president of public policy and relations at Medica who testified in opposition to both bills, said LB949 and LB970 are administratively burdensome and complicates Medica’s ability to pull off the bill’s objectives.

Medica is an insurance company that offers medical insurance plans throughout the Midwest. It covers over a million people in the Midwest, which includes approximately 90,000 Nebraskans.

“The cost of insulin is the actual underlying problem,” McLaren said. “This addresses a symptom which is the cost of people paying for it.”

According to McLaren, if the Legislature goes down this path of applying a cap to cost sharing for health insurance products, it puts insurers in the position of deciding what other areas to increase cost sharing.

The committee did not take immediate action on the bill.

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