The heartbreaking story of Alec Smith — the 26-year-old diabetic from Minneapolis who lost his health insurance, couldn’t afford his insulin, and then lost his life trying to ration what he had — prompted lawmakers last session in St. Paul to take action. Unfortunately, the Legislature failed to pass a measure that would have provided the lifesaving medication in emergency situations like Smith’s. No doubt the Alec Smith Emergency Insulin Act would have saved lives.
“I was really disappointed that the Minnesota Legislature wasn’t able to move forward,” U.S. Sen. Tina Smith, D-Minn., said in an exclusive interview this week with the News Tribune Opinion page.
While the state was falling short, Smith — suddenly with more urgency — was moving forward at the federal level. In June, she introduced a bill to help those who need insulin get it when they legitimately can’t afford it. Her Emergency Access to Insulin Act would provide federal grants so states and tribes can provide emergency access to insulin. Funding for those grants would come from a fee assessed to companies that overcharge for insulin. The fee would go up if a company attempted to raise prices to offset the fee, Smith said.
“The theory of this bill could apply to other lifesaving medicines beyond insulin,” she said. “I focused on insulin because there has been such pent-up need.”
(More broadly, another measure Sen. Smith has introduced, the Affordable Medications Act, is a more-comprehensive attempt to hold pharmaceutical companies accountable for increasing drug prices and to help bring down costs; lowering prescription-drug costs has been a priority for Smith since she became a senator in 2018.)
As the News Tribune reported last week, only three companies in the U.S. manufacture insulin: Eli Lilly, Sanofi, and Novo Nordisk. They hold the patents to the medicine and, according to Smith and others, frequently change the formula in small ways to extend their patents. This effectively prevents competition, which would lower prices — and the manufacturers’ profits.
“The amount of concentration and the monopoly of power of these big insulin manufacturers is having a terrible impact on American families,” Smith said. “These three big insulin manufacturers made a total profit after taxes in 2018 of over $14 billion. Meanwhile, Minnesotans and Americans are paying the price. So the theory (is) applying a fee to these manufacturers to help pay for the emergency needs that people sometimes find themselves in.”
As logical as it is, Smith’s legislation may be a long shot. She hasn’t been able to schedule a Senate hearing yet. And she’s butting heads with the lobbying power of Big Pharma.
The measure has bipartisan support, however — and bipartisan support for anything in D.C. these days can be a rarity and a success in itself. Sen. Kevin Cramer, R-N.D., is a co-sponsor.
“We are up against some big powerful companies, but I believe that our voices can be just as powerful if we focus,” Smith said. “What I would urge people to do is to reach out. If you think that this is an important issue, reach out and talk to people about it. If people lift up their voices and speak out on this to those who are in power, I think that’ll make a difference.”
Whether it comes from St. Paul or D.C., help in emergency situations — like the predicament Alec Smith found himself in — can literally be life or death. Let there be no more heartbreak. This is the sort of help Minnesotans and Americans alike should be able to expect from their government and from those elected to represent us.