Politicians at the state and federal levels have pushed for a cap on the price of insulin, which can cost hundreds of dollars a month, depending on the circumstances. For the thousands of people with diabetes in the Yakima area, capping insulin prices could help them better manage medical costs.
Most people’s bodies naturally regulate insulin, which helps process the blood sugar that people get from food. But people with type 1 diabetes can’t live without medicinal insulin because their bodies don’t produce it naturally. Some people with type 2 diabetes also need to take insulin injections, according to the American Diabetes Association.
Americans pay far more for medical insulin than people in other developed countries, according to the RAND Company. But recent political pressure could lower that cost for some Americans.
Political pressure
Several politicians have recently pushed for a cap on the price of insulin, but the limits would not apply to everyone equally.
Gov. Jay Inslee signed a bill earlier this month that will cap that price at $35 a month, according to The Associated Press. This limit will remain in place for all of 2023. The current maximum price for a 30-day supply of insulin in Washington is $100.
The limit only applies to people on state-funded health plans, such as people on certain types of Medicaid or who work for the state, according to the Seattle Times. It does not apply to private insurance.
A bill that would create a task force to find a way to cut insulin costs has passed the Washington Legislature and is awaiting the governor’s approval. This group is to submit a final report on solutions to the Legislative Assembly by July 2023.
In his 2022 State of the Union address, President Joseph Biden called for a national $35 limit on the price of a 30-day supply of insulin. The proposed limit in Biden’s infrastructure package, currently stalled in the Senate, would only apply to people with health insurance.
In February, Sen. Raphael Warnock, D-Georgia, introduced the Affordable Insulin Now Act in the Senate. This would limit co-payments on insulin to $35 for a 30-day supply starting in 2023. This limit would also only affect people with private insurance or certain health insurance plans, according to a press release from the Warnock office.
About 15% of Yakima County residents are uninsured, according to a 2021 estimate from the U.S. Census Bureau.
Diabetes in Yakima
Yakima has a higher rate of adults diagnosed with diabetes than the state. In 2019, 12.6% of adults in Yakima County had a diagnosis of diabetes, compared to 8.7% of adults in Washington, according to Yakima Valley Trendswhich contains data compiled by the Eastern Washington University Institute for Public Policy and Economic Analysis.
Yakima Neighborhood Health Services CEO Rhonda Hauff said her centers see about 2,000 patients with diabetes.
In Washington, one in three adults has prediabetes, according to the state Department of Health. People with prediabetes have a higher risk of developing type 2 diabetes.
According to the American Diabetes Association, low-income people are also disproportionately likely to develop type 2 diabetes due to systemic inequalities. According to the Centers for Disease Control and Prevention, Latinos, Native Americans, Black Americans, and some Pacific Islanders and Asian Americans are at a higher risk of developing type 2 diabetes.
The current price of a 30-day supply of insulin can vary widely depending on circumstances, from nothing to hundreds of dollars, according to healthcare providers. And a vial of insulin can last longer for some people, depending on how much they need.
Hauff said most YNHS patients are low-income. Various programs are available to help low-income people obtain insulin.
As a neighborhood health center, the YNHS can purchase insulin at the federal drug price, which is significantly lower than the retail price. Hauff estimated that most patients eligible for assistance pay about $10 a month for insulin.
YNHS Pharmacy Director Sarah Stephenson said her clinics have a sliding scale for patients without insurance. Health center staff can discuss insulin payment options with uninsured patients.
“It’s definitely more affordable,” she said of the sliding scale.
Stephenson said community members don’t always know about neighborhood health centers and how they can save money on medical bills. When she worked in a retail pharmacy, she sometimes referred people to the YNHS for more affordable care.
A life-changing price limit
A permanent state or federal limit on the price of insulin could affect thousands of people in the Yakima Valley.
“For some patients, major, life-changing,” Stephenson said of the potential impact.
She said in her previous work in retail pharmacies, she saw people having to choose between affording groceries and affording insulin.
For people who earn too much to qualify for support, insulin can quickly become a financial burden. Stephenson also said some people on Medicare end up with gaps in coverage, which can cause their monthly insulin prices to fluctuate dramatically.
“There’s always this group that gets stuck in the middle,” she said.
Hauff said that while a state or federal insulin price limit would not directly affect the cost of insulin for the YNHS, it would impact people in the community who are not currently eligible for the drug. ‘aid.
Jennifer Hilmes, a registered nurse and certified specialist in diabetes care and education at Yakima Valley Memorial Hospital, said she had patients who rationed insulin or borrowed it from other diabetics. Depriving yourself of the amount of insulin you need can lead to kidney problems, vision problems, increased risk of infection, and damage to your feet or nervous system.
A cap on the price of insulin could help end insulin rationing, she said.
“I think it would give people a better idea of what to expect each month, each time they go to the pharmacy,” she said.
She advised people struggling with insulin costs to speak with a healthcare provider and discuss their options.
