Lawmakers make bipartisan effort to expand insulin access

Iowa lawmakers are advancing bills to improve access to prescription drugs, especially insulin.

“It doesn’t matter if you’re Republican or Democrat,” said John Tagliareni, leader of an Iowa type 1 diabetes advocacy group. “If you’re diabetic, you need insulin.”

Rep. Steven Bradley, R-Cascade, led the bill the first of the two bills, House File 262, which would allow pharmacists to refill up to a month’s worth of a prescription without a doctor’s sign-off in emergency situations.

Rep. John Forbes, D-Urbandale, spoke in favor of the bill on the House floor Monday. Forbes owns the Urbandale Medicap pharmacy.

“We run into these situations where a patient walks in the pharmacy on a Friday night and they need a refill on their insulin,” Forbes said. “It’s difficult sometimes to get a hold of a doctor on a Friday or a Saturday night, so this will allow us to refill their insulin one time per twelve months.”

Current Iowa law allows pharmacists to issue up to three days worth of a prescription — enough to get a patient through a holiday weekend, in a pinch.

If passed into law, House File 162 would cover prescriptions like insulin, inhalers and EpiPens, which are not available in three-day doses.

“If you use crazy amounts of insulin, a full vial or a full pen is going to give you at least 5, 6 days,” said Tagliareni of T1International. “For most of us, it’s probably 10 or 14 day supply.”

The House approved the bill unanimously.

The House also passed House File 263, which would cap out-of-pocket expenses for an insulin prescription at $100 a month for health insurance plans regulated by the state. Rep. Tom Jeneary, R-Le Mars, led debate on the bill.

Rep. Liz Bennett, D-Cedar Rapids, said in support of the bill that no patient should “go broke” because they rely on insulin to live.

“I hope this will build in us the awareness that no one in America should go without the medication they need because of funds,” she said.

Tagliareni called the bill “a good bad thing.” It would help people with certain insurance, he said, but not all Iowans who need insulin. The bill also does not include language for people who need multiple different insulin prescriptions each month.

Still, he said, for those covered by the bills, it would be “awesome.”

The AARP of Iowa released a statement Tuesday applauding the House’s passage of the co-pay bill.

“More than 260,000 Iowans have been diagnosed with diabetes or pre-diabetes and require insulin,” AARP State Director Brad Anderson wrote. “The fact that the rising costs of insulin has forced many Iowans to make the dangerous choice to skip insulin doses is unacceptable for a drug invented nearly 100 years ago.”

The House voted 89-2 to move the bill. Both bills may now be considered in the Senate.

Similar bills appeared in the 2019 and 2020 sessions, but were never successfully signed into law. 

In 2019, lawmakers considered two different versions of the emergency refill law: one which would require insurance agencies to cover an emergency refill, and one which did not mandate insurance coverage. Lawmakers did not reach a compromise.

The House passed in 2020 a bill which set the same $100 cap on insulin. The Senate never considered the bill after COVID-19 disrupted the session.