ST. PAUL — Weeks after legislative leaders said they hoped to have a bipartisan plan to provide free insulin to diabetics in crisis, lawmakers appeared no closer to reaching a compromise as their self-imposed deadline approached.

Lawmakers and representatives from the governor's office for a month have been holding occasional meetings behind closed doors to come closer to an agreement. But following a meeting on the Capitol complex on Friday, Nov. 15, the members didn't have an answer.

And stakeholders didn't seem optimistic about their ability to reach one that would satisfy both Senate Republicans and House Democrats ahead of the Wednesday deadline.

The latest push to start an emergency insulin program comes after months of stops and starts around the issue. In October, Gov. Tim Walz called on lawmakers to bridge two proposals aimed at providing access to insulin for diabetics who couldn't afford it.

In Minnesota, about 330,000 adults have been diagnosed with either Type 1 or Type 2 diabetes, according to the state Department of Health, and roughly 18,000 new cases are diagnosed annually. And in recent months, several Minnesotans have reported rationing insulin due to skyrocketing prices, with some experiencing fatal complications.

Affordable insulin advocates, including the mothers of young Minnesotans who'd died after rationing insulin, have continued to press lawmakers for action in the months after the legislative session came to a close. And they've said they support a combination of a Democratic-Farmer-Labor plan and a Republican plan. Above all, they've urged lawmakers to act quickly to prevent additional deaths.

And a month ago, it looked like they might get a compromise plan from the Legislature.

30-day goal

Legislative leaders and the governor last month committed to finding a compromise that could pave the way for a special legislative session. And they started a 30-day goal to reach an agreement.

Democrats and Republicans had each put forth a plan they believed could get insulin to Minnesotans who need it. And authors of each bill, along with other lawmakers and governor's staff committed to working toward a combination of the two.

But the sticking points around the bills have remained. Republicans disagree with Democrats' plan to charge a fee to the manufacturers that would fund insulin supplies for low-income people without insurance or with high-deductible insurance plans because they feel it's punitive. And Democrats say it's important to hold manufacturers accountable for the steep prices.

Senate GOP lawmakers' plan would require insulin manufacturers to supply insulin to needy patients with diabetes who are not already on a public health program. And while Democrats said that could be part of a larger insulin access plan, they couldn't accept a program without an emergency component.

Pharmaceutical Research and Manufacturers of America, or PhRMA, has voiced opposition to both bills.

Lawmakers again entered negotiations on Friday morning to parse the two bills. They didn't offer comments to reporters outside the conference room where they met and they emerged from the meeting without a plan three days ahead of the date they'd set to reach a compromise.

A day prior, on World Diabetes Day, Walz proclaimed the date Diabetes Day in Minnesota and urged legislators to find a proposal Democrats and Republicans could both support so that he could call them into a special session to pass it.

"Minnesotans are dying," the first-term governor said in a news release. "I am encouraged that the House and Senate have been meeting to work out their differences but I hope this proclamation serves as a call to action for legislators. Please remember these are real Minnesotans who need relief and they need to get a deal to my desk as soon as possible.”

U.S. Sen. Tina Smith, right, speaks to doctors, diabetes experts and the mother of a son with Type 1 diabetes at Children's Minnesota in St. Paul on Friday, Nov. 15, 2019. Dana Ferguson / Forum News Service
U.S. Sen. Tina Smith, right, speaks to doctors, diabetes experts and the mother of a son with Type 1 diabetes at Children's Minnesota in St. Paul on Friday, Nov. 15, 2019. Dana Ferguson / Forum News Service

Smith calls for price cap

At the federal level, another bipartisan push for emergency insulin access has also met a hurdle in the Senate.

U.S. Sen. Tina Smith, D-Minn., and Sen. Kevin Cramer, R-N.D., have put forth proposals to bring down the cost of insulin and penalize drug manufacturers for "excessive price hikes." But Senate leaders haven't been willing to bring them up for a vote, Smith said Friday.

"These aren't Republican or Democratic issues, these are issues about how families can be healthy and take care of their little kids who might be living with Type 1 diabetes," Smith said.

Smith on Friday met with doctors, diabetes experts and family members of children with diabetes at Children's Minnesota's Pediatric Diabetes Center to learn more about the impact of the drug's skyrocketing prices.

Smith and Cramer also introduced legislation this week that would allow for the study of insulin affordability at the federal level.

“50,000 North Dakotans need insulin to live, yet we struggle to understand why it is becoming so expensive and what we can do to change that. We need answers,” Cramer said in a news release Thursday. “This legislation is an investment in fixing the insulin affordability crisis.”

Jennifer Rooney, of Lino Lakes, said her family has insurance but spent more than $13,000 over the last five years to foot the bill for her insulin and supplies for her 11-year-old son who has Type 1 diabetes. Rooney said she appreciated the urgency about the discussion around access to emergency insulin for Minnesotans who can't afford it, but she hoped to see that same push for bringing down the price of insulin overall.

"Having someone who is underinsured go into DKA (diabetic ketoacidosis) is terrible, but what about all the rest of us?" Rooney asked on Friday. "In my mind, that's really putting a BandAid on the problem. Let's get to the source of the problem, let's eliminate that so everyone can benefit."