Rep. Jeremy Munson speaking in the House Health and Human Finance Division (Committee)
Yesterday, Governor Walz held a press conference with three young adults to punctuate his frustration at not having the DFL plan for free emergency insulin pass the Minnesota Senate. The Senate has offered its own plan, authored by Senator Pratt. Here is my response.
It may surprise some people to know that I, a fiscally conservative Republican, voted for the DFL plan, dubbed the “Alec Smith Emergency Insulin Act” for the young man who died rationing insulin. At that point, the only thing Republicans and Democrats in the House disagreed on with this very limited plan, which would affect a relatively small number of extreme cases, was how it should be paid for.
The House Democrats were adamant that we should be “sticking it to the pharmaceutical companies.” Republicans, myself included, voted to pay for it from the Health Care Access Fund, paid for with sick tax dollars (a tax, which unfortunately we were already stuck with, thanks to the Governor’s insistence).
I have no love for the pharmaceutical companies, and I am sure they have no love for me. I was an author on the bill requiring price transparency for Pharmaceutical Benefits Managers, and I support other free-market initiatives that would remove their ability to set prices in the market.
Those were the stakes last session: feel-good revenge against big Pharma vs. paying for a program with dollars already destined to pay for emergency health care. Democrats demanded the feel-good option, and a last-minute compromise that would have saved the bill in the House went down in flames.
Now the Senate is offering a plan, building on MNSure, a government program that has only recently recovered from its disaster status. In this plan, MNSure would serve as a clearinghouse for insurance that covers insulin. A website, MNSure is now only able to function to guide people to the insurance policies that exist in the post-ACA market for individuals or to MinnesotaCare, Medicare, or Medicaid if they qualify. Currently, we have no way to create new insurance policies that would cover low-cost insulin for diabetics because the Federal Government sets the limits for what gold, silver, and bronze plans will cost and what they will cover.
You don’t have to believe me. That’s what the health insurance companies testified at the HHS Finance committee on Sept. 26. At that meeting, the author of Alec Smith Act presented new language for his bill that would expand the scope of the bill to cover people with incomes up to $150,000, who have insurance. The original, more limited bill would have cost $1.4 million dollars, according to data presented to the committee last session. We have no fiscal note for this new language and it's hard to imagine it will cost less when the number of people who would qualify would greatly increase. I don't think the cost is important at all to the author or the House DFL because they know the bill can't pass with a high price tag. I think they want it to fail so that they can use it in the next election.
Fortunately, the health insurance companies have put different types of insulin into their coverage, starting with next year’s plans. I made a video pointing out that some people with diabetes, with doctor instruction, might benefit from buying insulin currently available over the counter at Walmart for just under $25, where you don’t even need a prescription. The American Diabetes Association agrees this is a better option than rationing analog insulin. My point was to offer hope to those for whom these solutions would work. If Walmart's insulin didn’t work for them, perhaps they could find a short term solution to purchase their preferred type of insulin until the new plans kicked in next year. My point, which seemed to be lost, was that nobody should be rationing insulin, and nobody should be hoping that government, which in some ways helped to create this problem, was going to solve it.
Instead, activists distorted my argument, and one of the testifiers this morning mentioned it again. But that’s OK, as a politician I know that it makes for a good sound bite, to attack my argument as simplistic, without actually addressing it.
The problem of insulin affordability is a serious and life-threatening problem, especially for those with certain types of diabetes. But politicians who hold out hope to activists that something could be done by the government before the end of the year to solve the problem of emergency insulin are not telling the truth. A politician who tells you that they will solve your issue (really, everybody’s issues) with more government is also not telling you the truth. What I am trying to do is uncover ways that empower individuals and communities to solve our own problems and stop others from preventing solutions from working.
Gov. Walz holding another news conference to pound on the podium isn’t going to create a solution to the problem of high prescription drug prices, including insulin. He is asking for more closed-door, secret sessions of government elite, and ignoring opinions and debate of 199 other elected legislators. Activists for a single type of a single disease demanding a solution to the problem isn’t going to make this happen either. What we do know is that “emergency” legislation usually comes too late and at the expense of the next “emergency.” The more government gets involved in health care, the more politics will interfere in your health care.