General Assembly passes bill limiting insulin copays

STATE HOUSE – The General Assembly today approved legislation sponsored by Sen. Melissa A. Murray and House Speaker Pro Tempore Brian Patrick Kennedy to limit insured patients’ copays for insulin used to treat diabetes to $40 for a 30-day supply. The bill now goes to the governor’s desk.

“Insulin is both very widely used and absolutely critical to the lives of people with diabetes, many of whom are seniors or disabled people living on low fixed incomes. Unaffordable insulin costs are a serious threat to public health. According to the American Diabetes Association, about a third of the approximately 100,000 diabetes patients in Rhode Island use insulin, and a quarter of those patients ration their insulin. No one should have to choose between paying for their life-saving medication, keeping their lights on, or having enough groceries,” said Senator Murray (D-Dist. 24, Woonsocket, North Smithfield).

The cost of insulin has risen sharply in the last several years, and is much higher in the United States than in other countries. Millions of Americans depend on insulin for the management of diabetes.

“This legislation will assist many Rhode Island families that have struggled with the cost burden of paying for food, shelter and other necessities or for insulin,” said Representative Kennedy (D-Dist. 38, Hopkinton, Westerly). “That isn’t just cost-prohibitive for those who need the drug, it’s disastrous both financially and medically for those who need multiple doses of insulin every single day just to survive. A growing number of people cite affordability as the reason they ration their insulin, with some reports of deaths due to insulin rationing. According to recent statistics, 7.9 percent of adults in Rhode Island have been diagnosed with diabetes, making this a widespread tragedy.”

The legislation (2021-S 0170B, 2021-H 5196A), which is included in the Senate’s prescription drug affordability legislative package, applies to all insurance plans that cover insulin. Under the bill, insurers would be required to cap the total amount that any covered person is required to pay for covered insulin at $40 for a 30-day supply. It also forbids that coverage from being subject to any deductible. The bill does allow insurers to charge less, if they choose.

In 2018, 34.2 million Americans — or 10.5 percent of the population — had diabetes, with an additional 1.5 million Americans diagnosed every year. Beyond the sheer prevalence of the disease across the country, the costs of diagnosed diabetes have increased from $245 billion in 2012 to $327 billion in 2017, according to the American Diabetes Association.

As a result, at least 18 states have implemented some type of monthly copayment cap for insulin.

The pancreas of a person with Type 1 diabetes lacks the ability to make insulin. Insulin shots are the only way to keep blood glucose levels down in Type 1 diabetes sufferers. Diabetes is the seventh leading cause of death in the U.S. Its complications, including heart disease, stroke, amputations, blindness and kidney disease, are both serious and expensive. 

The sponsors worked extensively with the American Diabetes Association, along with health insurers and pharmacies to craft the legislation.

Stephen Habbe, director of State Government Affairs for the American Diabetes Association, testified in favor of the bill, saying, “By ensuring that insulin is affordable, people with diabetes are better positioned to manage their glucose levels to stay healthy and productive. By keeping insulin affordable, we can help keep people with diabetes out of the ER and the hospital, and away from expensive and potentially disabling or deadly complications.”

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