When it comes to setting up a system to provide emergency insulin for diabetics who can’t afford it, nothing has been easy with the Minnesota Legislature. Not even the declaration of victory.
Before the 2020 session was forced into COVID-related recess, the DFL House and the GOP Senate appeared on the cusp of a deal that would rely mostly on insulin makers to provide the hormone to lower-income uninsured people. And on Tuesday morning, House Speaker Melissa Hortman said it was one of the few non-COVID related bills that could be taken up when lawmakers return to St. Paul on April 14.
But later, just after the House passed the one bill that was on the agenda for the three-hour emergency session on Tuesday — a bill to clarify workers’ compensation for health care workers and first responders — the lead GOP lawmaker on the bill held a press conference to announce an emergency insulin deal.
Sen. Scott Jensen, R-Chaska, said a 10-member conference committee had enough agreement to put a bill into final form. All five Senate conferees and three of the four House conferees were willing to go along. “Just when you thought that it might not happen, it happened,” he said. “I feel like I’ve been going through 48 or 72 hours on ‘Let’s Make a Deal.’”
But if there was a deal, where were the other dealmakers? Jensen was asked.
Jensen blamed the need for social distancing for his solo performance, but as soon as he was finished, Hortman said the agreement still needed to be finalized.
That’s because under an agreement among the four legislative caucuses and Gov. Tim Walz, issues that are to be brought up in the type of one-day sessions as happened Tuesday must have everyone’s sign-off ahead of time.
The insulin bill did not in time for the Tuesday session, Hortman said. “This bill didn’t hit that very high bar in time,” she said. “It could, hopefully, have everyone’s approval and we can hopefully proceed when we come back on the 14th.”
Finger-pointing. And the finger
The issue has produced plenty of partisan finger pointing since it first emerged in 2018 after the death of Alec Smith, a Richfield man who couldn’t afford his insulin and tried to stretch his supply to his next payday. DFLers accused Republicans of doing the bidding of Big Pharma, who they blamed for ratcheting up insulin prices and making the hormone unaffordable. The GOP said the DFL was more interested in punishing the big companies that resolving the problem.
Advocates, however, just wanted a bill, and said other diabetics could die as lawmakers dallied. They were optimistic that the deal Jensen proposed before the break would break the logjam.
The bulk of the bill had been mostly agreed to before the March 17 COVID-caused recess. Rather than impose fees on insulin makers, the program would rely on the manufacturers’ existing patient assistance programs. The companies would supply the hormone both for an emergency insulin program, which allows a short-term supply for those without insurance, and a long-term program for ongoing supplies. The only unresolved items were over copays, whether the programs would sunset and how much companies that don’t take part would be fined.
According to Rep. Mike Howard, DFL-Richfield, the emergency program will not sunset, though the long-term program will end in December of 2024. While Howard disagreed with the sunset, he said lawmakers can revisit the issue before then. The fines for reluctant drug companies would be up to $3.6 million and the patient co-pays would be $35 for a 30-day supply of emergency insulin and $50 for a 90-day supply.
But even a deal didn’t end the partisan arguments. On Tuesday, House Majority Leader Ryan Winkler sidled up to Jensen’s press conference to say he thought the Republican was grandstanding, taking credit for work that lots of lawmakers did.
Shortly after, Senate GOP staff and legislators criticized the DFL for both crashing their press conference and for not taking up the issue Tuesday, and instead pushing it off of next week. The Senate GOP also included a video of Winkler that shows him making an obscene gesture.
— Paul Gazelka (@paulgazelka) April 7, 2020
At his own press conference after the Senate had passed the workers’ compensation bill, Gazelka was more conciliatory.
“I believe there was a deal, but we weren’t quite ready,” he said of the insulin package. “It looks like there is a deal that is done and I think we’ll get that when we get together next session. Which is really good news. Great news.”
Lija Greenseid, an insulin for all activist and the mother of a child with Type 1 diabetes, said the announcements Tuesday made her hopeful. “But I was hopeful last session as well,” she added. And the COVID crisis and its potential disparate impact on diabetics makes the bill more urgent.
“It’s more important than before that bill is passed and signed by the governor next week,” she said. “People with diabetes are facing a crisis right now with the combination of job loss and the high cost of insulin. Alec’s bill will provide a critically needed safety net.”