Senate GOP takes shameful vote to block cap on insulin costs

August 8, 2022 8:00 am

U.S. Senate Republicans blocked legislation to cap insurance co-pays for insulin at $35. (Photo by Scott Eisen/Getty Images)

More than 30 million Americans have diabetes, including more than 230,000 Iowans. That means if you don’t have it yourself, someone close to you almost certainly does.

I have loved ones and friends with the disease. One particularly special person in my life was diagnosed with Type 1 (juvenile) diabetes when she was a toddler. Needle sticks and insulin injections, and later an insulin portal, have been part of her life as long as she can remember.

Now a young adult, she just landed her first job that provides health insurance, to the enormous relief of her family. But having health insurance won’t protect her from price-gouging by opportunistic drug companies and drug middlemen. The price of insulin, a drug developed more than a century ago, has grown far faster than the rate of inflation.

“One vial of Humalog (insulin lispro), which used to cost $21 in 1999, cost $332 in 2019, reflecting a price increase of more than 1,000%. In contrast, insulin prices in other developed countries, including neighboring Canada, have stayed the same,” according to the Mayo Clinic.

Out-of-pocket costs depend on health insurance plans. But some high-deductible plans require patients to shell out $7,000 to $8,000 out of pocket before insurance pays a dime toward insulin costs. People die because they can’t afford insulin and try to ration it. It’s unconscionable.

That’s why it’s so disappointing that Republicans in the U.S. Senate — including Iowa Sens. Chuck Grassley and Joni Ernst — succeeded in stripping a provision out of a larger bill on Sunday that would have capped insurance co-pays for insulin at $35 a month.

The Democrats’ so-called Inflation Reduction Act (which would not, in fact, have much effect on inflation) takes some long-overdue actions related to health care. It allows the federal government, for the first time, to negotiate prescription drug prices under Medicare. It renews the government subsidies and tax credits for the Affordable Care Act. And, until Sunday, it would have helped millions of Americans with private health insurance who still can’t afford lifesaving insulin.

Big Pharma, the drug-makers, oppose the measure and they spend millions on political donations and hundreds of millions on lobbying. Because there has not been enough Republican support in the Senate to move a bipartisan insulin bill on its own, Democrats included it in the larger bill that they’re trying to enact through a process called reconciliation.

Reconciliation has the advantage of allowing Democrats in the evenly divided Senate to pass legislation without the 60 votes that most bills need to avoid a filibuster. The disadvantage is that only budget-related legislation qualifies, as determined by the nonpartisan Senate parliamentarian. The rules official said the co-pay measure didn’t qualify, giving Republicans an opening to knock it out of the bill.

That’s what happened early Sunday. Seven Republicans voted with Democrats to keep the provision in the bill, but it still failed 57-43 – three votes shy of overcoming the objection. They could have chosen to leave it, as they did with a similar cap on out-of-pocket costs for insulin under Medicare. Instead, they chose to continue subjecting working people to choosing between putting food on the table or paying the electric bill and buying the insulin they need to stay alive.

That’s shameful – and it’s bound to be an issue in this year’s midterm elections.

I hope Democrats give Republicans a chance to reconsider after they hear from their constituents during the August recess. If the GOP, including Ernst, can reverse their disastrous vote to deny health care and benefits to military veterans, they can still do the right thing for diabetics. People who can’t afford insulin can’t afford to wait until after the election.’

Update: Grassley’s staff objected after this column was published to the fact that I — and most other mainstream media — omitted that all 50 Republicans voted for an alternative amendment offered by Republican Sen. John Kennedy of Louisiana that would have reinstated a narrow Trump administration rule that never took effect but would have offered lower-priced insulin at Federally Qualified Health Centers. President Joe Biden, who supports a cap on insulin costs, rescinded the rule, arguing it would have created additional administrative work and resulted in reduced resources at such centers, according to the Associated Press. No Democrats voted for the amendment and it failed.

However, Kennedy was one of the seven Republicans who voted to keep the Democrats’ insulin co-pay cap in the bill. Good for him.

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Kathie Obradovich
Kathie Obradovich

Editor Kathie Obradovich has been covering Iowa government and politics for more than 30 years, most recently as political columnist and opinion editor for the Des Moines Register. She previously covered the Iowa Statehouse for 10 years for newspapers in Davenport, Waterloo, Sioux City, Mason City and Muscatine.