Push is marching through Congress to help millions of Americans cope with high insulin prices
WASHINGTON — Shane Thompson knows the nightmare faced by diabetics who struggle to get the insulin needed to regulate their blood sugar.
The Plano engineer was first diagnosed with type 1 diabetes as a senior student about 15 years ago. For months before, she had been losing weight and experiencing extreme thirst, hunger and fatigue.
Then she caught what she first thought was a bad flu. She ended up in the intensive care unit, where doctors were stunned by her extremely high blood sugar and told her she nearly died.
“To experience this is terrifying,” Thompson said.
Before he could land a “real job,” Thompson had no health insurance and watched as his insulin bill of $300 a month or more quickly swallowed up paychecks from his part-time job. This left her trying to get free samples in a bid to soften the financial blow.
Congress is debating proposals to help patients deal with issues of access and cost. The House voted last week to cap patient out-of-pocket expenses at $35 per month.
An estimated 37 million Americans have diabetes, including about 2.7 million in Texas, where the situation is compounded by relatively high rates of uninsured people.
Even though insulin has been around for more than a century, its price has skyrocketed in recent years and has forced many diabetics to ration doses. state-regulated insurance schemes and therefore a relatively small segment of the population.
There is bipartisan agreement in Washington that runaway insulin prices — and prescription drug prices in general — require federal action, but very different views on how best to address them.
Democrats have pushed various regulatory approaches, such as Medicare negotiating drug prices, while many Republicans have resisted what they describe as government intervention in the private sector and a slippery slope toward “price fixing.” “.
As a bipartisan pair of U.S. senators struggle to find a compromise approach, the House last week sought to give them a boost.
Democrats united Thursday behind the bill that would cap out-of-pocket expenses for Americans on private health insurance or Medicare at $35 a month. The legislation drew a dozen Republican votes and passed 232-193.
That proposal has been removed from the Democrats’ sweeping climate and social spending agenda, formerly known as “Build Back Better,” which has stalled in the Senate.
The Texas delegation split along party lines, with Democrats all voting yes and Republicans voting no. The only exception was Republican Representative Kevin Brady of The Woodlands, who did not vote.
Rep. Colin Allred, D-Dallas, attempted to shine a light on the issue of insulin pricing, inviting Thompson as a guest at the 2020 State of the Union address. In an interview, he quoted statistics that one in four diabetics report rationing their insulin.
“What that really means is that they are risking their lives because they cannot afford their medicine.” Allred said. “So it’s important to me to keep costs down and I’ll keep trying to find ways to reduce costs.”
A number of House Republicans opposed the legislation as a move toward government price controls that would stifle innovation.
Representative Beth Van Duyne of Irving criticized the bill as a government takeover of private health care and said it would do nothing to reduce the true cost of insulin for Americans.
“In effect, it allows manufacturers to raise their prices because insurers pass them on to patients via higher premiums,” she said in a statement.
She said she instead supports legislation that would take steps like requiring the Centers for Medicare and Medicare Services to publish more information about prescription drugs to advance transparency, lower the annual spend threshold in Medicare and permanently allow high-deductible health. is considering waiving insulin deductibles.
Some criticism was bipartisan. For example, Rep. Lloyd Doggett, D-Austin, told the House he fully supports the bill because it provides some relief to policyholders who are struggling to afford insulin.
But he also disputed how it would bring that relief.
“Instead of tackling price gouging for pharmaceuticals, this bill simply changes the way big pharma is rewarded,” Doggett said. “Since this bill does not reduce insulin prices by a penny, all of us who are insured will ultimately pay through our premiums.”
The bill offers no help, he said, to the 28 million Americans — including more than 5 million Texans — who lack health insurance.
Allred acknowledged this dynamic and noted that the uninsured rate in Dallas County exceeds 20%. He supports a range of proposals to insure more people and tackle prescription drug prices through negotiations, as the VA does.
But he said the insulin bill represents a good first step that can help break the ice to get something bipartisan moving. He said he hopes it proves more appealing to Senate Republicans who have adamantly opposed any move toward price negotiation.
“Now the question is, can we get 10 Republican senators to join us in doing this?” Allred said.
Sen. Jeanne Shaheen, DN.H., said recently that she reached a tentative agreement with Sen. Susan Collins, R-Maine, on a bipartisan bill to cut insulin costs. They could use as a basis the legislation they introduced earlier that would reward drug companies that cut overall insulin prices.
Senate Majority Leader Chuck Schumer, DN.Y., has indicated that insulin-related legislation could come to the Senate later this spring.
Republicans are likely to offer additional ideas on prescription drugs. Senator John Cornyn of Texas, for example, has proposed legislation aimed at reducing drug costs by preventing drug companies from playing with the patent system to block generic versions of drugs from the market.
When Plano’s engineer Thompson was first diagnosed with diabetes, she was months away from being commissioned as a Navy officer. Her diagnosis rendered her medically disqualified and dashed her plans for a career in uniform.
Today, she is a project manager in an engineering firm where she focuses on the development of private sites.
Thompson said she’s lucky to have health insurance, but her insulin can still cost her up to $90 a month.
She welcomed caps on insulin costs, both for her own peace of mind and out of consideration for those less fortunate who ration their doses.
Going without medication is not an option.
“If I don’t take care of myself, if I don’t have insulin, then I die,” she says.