Insulin

Hey, remember the Inflation Reduction Act?

Remember how one of its healthcare provisions includes putting a copay cap of $35/month on insulin for Medicare enrollees?

Remember how Congressional Democrats & President Biden attempted to make the $35/mo insulin cap apply to ALL Americans as part of the defunct Build Back Better bill but had to settle for it only applying to the ~65 million on Medicare?

Well, guess what just happened? Via Rebecca Robins & Christine Hauser of the New York Times:

via MNsure, Minnesota's ACA exchange:

ST. PAUL, Minn.—A recent study found that more than 1.3 million Americans with diabetes rationed their insulin because of cost concerns by skipping doses, taking less insulin than needed, or delaying buying insulin to save money. During National Diabetes Month, MNsure and the Minnesota Board of Pharmacy remind Minnesotans that the Minnesota Insulin Safety Net Program provides fast, reliable help for those who need insulin and may be struggling to afford this life-saving drug.

The Minnesota Insulin Safety Net Program has two key components, depending on individual needs:

No, this is not a repeat, though it may sound like it. From March:

Since the collapse of the Build Back Better Act in the U.S. Senate last December (reminder: It passed the House but came to a screeching halt when all 50 Republican Senators along with conservative Democrat Joe Manchin refused to support it), Congressional Democrats have been quietly trying to put at least some of the pieces of the bill back together in an attempt to salvage something out of President Biden's signature social spending agenda.

...One of the other provisions of BBB which some members of Congress are trying to save has been reintroduced as a standalone bill in both the House (H.R. 6833) and Senate (S.3700), the Affordable Insulin Now Act.

The AINA does two simple (but important) things:

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Since the collapse of the Build Back Better Act in the U.S. Senate last December (reminder: It passed the House but came to a screeching halt when all 50 Republican Senators along with conservative Democrat Joe Manchin refused to support it), Congressional Democrats have been quietly trying to put at least some of the pieces of the bill back together in an attempt to salvage something out of President Biden's signature social spending agenda.

Personally, I'm most focused on making the enhanced/expanded ACA subsidies under the American Rescue Plan (ARP) permanent, of course, which the Congressional Budget Office estimated would cost roughly $220 billion over 10 years to implement. If the ARP subsidies are allowed to expire (which would revert the ACA back to the original subsidy formula, including bringing back the hated "Subsidy Cliff"), over 13 million Americans would find their health insurance premiums jump by an average of over $700/year apiece, with some households seeing theirs skyrocket by as much as $17,000/year (that's not a typo).

 

via MNsure:

The mother of a Minneapolis man who died because he could not afford his Type 1 diabetes medication is asking Minnesotans with an urgent need for insulin to seek assistance through a state program that she helped champion.

In a new video called the “Alec Smith Story,” Nicole Smith-Holt urges anyone struggling to afford their insulin to sign up for the Minnesota Insulin Safety Net Program. Her son Alec died in 2017 at the age of 26 from ketoacidosis after rationing his insulin to make it last longer.

“I encourage anyone who has diabetes and struggling to afford the medication to keep advocating for yourself,’” Smith-Holt said. “I don’t want someone in an emergency like Alec was to be turned away at the pharmacy or start rationing their insulin. You have options.”

via MNsure:

ST. PAUL, Minn.—The Minnesota Insulin Safety Net Program was created to help Minnesotans who face difficulty affording their insulin. The program is made up of two parts: the urgent need program and the continuing need program.

  • The urgent need program—eligible Minnesotans can receive a 30-day supply of insulin immediately at their pharmacy for no more than $35.
  • The The continuing need program—eligible Minnesotans can receive up to a year supply of insulin for no more than $50 per 90-day refill.

To be eligible for the urgent need program, you must—

This isn't technically ACA-related, but it's certainly healthcare related and it was posted via the Minnesota ACA exchange, MNsure:

ST. PAUL, Minn.—The Minnesota Insulin Safety Net Program, launched earlier this year, provides a pathway for Minnesotans in urgent need of insulin (less than a 7-day supply on hand) to access the life-saving drug through their pharmacy. The program—implemented by MNsure, the state's health insurance marketplace, and the Minnesota Board of Pharmacy—was created to help Minnesotans facing difficulty affording their insulin.

The Insulin Safety Net Program is made up of two parts: 1) The urgent need program for eligible Minnesotans to receive a once-per-year 30-day supply of insulin immediately at their pharmacy for no more than a $35 copay; and 2) The continuing need program for eligible Minnesotans to receive up to a year supply of insulin for no more than $50 per 90-day refill.

Interested individuals should visit MNinsulin.org to see if they qualify and learn how to apply.

Who qualifies?

via MNsure:

MNsure offers enrollment opportunity for Minnesotans newly eligible for financial help due to decrease in income

  • MNsure is the only place to get financial help to lower the cost of health insurance

Starting May 11, 2020, MNsure is offering an ongoing special enrollment period for Minnesotans who experience a decrease in household income and become newly eligible for advanced premium tax credits (APTC). Those looking to enroll will need to have had health insurance that meets the standards in the Affordable Care Act, also known as minimum essential coverage (MEC), for one or more days in the 60 days immediately preceding their decrease in household income.

Minnesotans must act within 60 days after they experience a decrease in household income to be eligible. 

via MNsure:

MNsure releases Request for Proposal for the Minnesota Insulin Safety Net Program’s Public Awareness Campaign

  • Submissions accepted until May 26, 2020

ST. PAUL, Minn.—On April 15, 2020, Governor Walz signed the Alec Smith Insulin Affordability Act to provide relief to Minnesotans struggling to afford their insulin. MNsure, the state’s health insurance exchange, is responsible for a creating a public awareness campaign to promote the Insulin Safety Net Program. The public awareness campaign will inform Minnesotans in urgent need of insulin how to access the state’s safety net program, and highlight the availability of insulin manufacturers' patient assistance programs.​ 

The request for proposal (RFP) seeks proposals from qualified firms or contractors capable of producing a statewide public awareness campaign to increase awareness of the Insulin Safety Net Program. The anticipated time frame of the campaign is July 2020 through June 2023.

This just in from MNsure, the Minnesota ACA exchange:

All private health plans offered on the MNsure marketplace limit the out-of-pocket cost to enrollees for insulin prescriptions in 2020. Each of MNsure's four insurers are offering either low-cost or free insulin benefits, meaning consumers purchasing plans through MNsure will pay no more than 25 dollars per month for insulin.

"The rising cost of insulin has put a huge financial burden on many families across Minnesota," said Nate Clark, MNsure CEO. "It’s so important to have access to insulin at an affordable price. We encourage all those looking for prescription insulin coverage to check out the plan options at MNsure.org."

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