Biden Didn’t “Triple” Insulin Prices. But What Exactly Has He Done?
I’ve written before about how conservative commentators are peddling a false narrative that one of Biden’s first actions as president was to increase the price of insulin.
To reiterate: Biden didn’t raise the price of insulin. What did happen was that the Biden administration paused a last minute Trump-era rule that put new administrative burdens on the 340B prescription drug program — one of the only existing programs designed to help uninsured people afford their medicine. The rule solved nothing, and hadn’t even gone into effect yet when Biden took office. But when the Biden admin announced they would be pausing the implementation of this rule, it was January — the same month health insurance deductibles reset back to zero, and people start having to pay out of pocket for their prescriptions for the first time in a while, or perhaps ever, if they’re on a new plan, or if their plan has a new formulary. It became easy to pin the blame for the high list prices everyone was newly encountering on the new president. The Biden admin didn’t take a strong PR stand against the idea, and Biden’s opponents have run with it.
So what has he done for people who use insulin so far? The legislature has yet to take up any prescription drug-related bills, nor has Biden indicated that to be a priority for the time being. Instead, the federal government has been focused on the COVID-19 stimulus package, which Biden signed last week, and which does have provisions in it designed to expand health insurance coverage. It does so by building on the structures set in place by the ACA:
It expands subsidies for plans purchased through the Obamacare exchange
It attempts to incentivize Medicaid expansion in states that haven’t already done so
It covers 100% of COBRA costs for the recently unemployed until September
It covers 100% of premiums for plans purchased on the exchange for those who income is below 400% of the federal poverty level
It caps premiums at 8.5% of income for those earning more than 400% of the federal poverty level purchasing exchange plans through expanded tax credits
The CBO estimates that the combined impact of these new policies will provide coverage to an additional 1.7 million people. It’s unclear exactly how many uninsured people reside in the U.S. right now, but the most recent figures are from 2019, when there were an estimated 29 million uninsured. Considering that there are likely to be more people uninsured in 2021 as a result of the pandemic, the stimulus bill sews up a relatively small hole in the coverage patchwork. More will need to be done to expand health insurance coverage if universal health care is the goal.
Plus, the subsidies expire after two years, and one can imagine a new, protracted battle in the story of the ACA over extending them when the time is up. For people with diabetes, a capped premium certainly isn’t a bad thing, but the bill doesn’t reduce the deductibles or copays that so bedevil people who use insulin. Overall, the bill reinforces the role of private insurance companies, opting to have the federal government take on the exorbitant costs of COBRA for recently unemployed rather than envision a new role for Medicare, as some members of Congress proposed.
I joked on Twitter last week that it feels like a kind of moral injury to have to explain deductibles and defend Biden whenever the lie is told that he hiked the price of insulin. What I really mean is that as a person who uses insulin, I want people to understand what’s really going on, but I’m not ready to let Biden off the hook. The right wing media is attempting to run away with the narrative that it is Trump and the Republicans who are the ones who care about people with diabetes. While insulin wouldn’t be the first subject of a bad faith political attack, I’d argue that Biden and the Democrats need to accomplish more if they want to convince people otherwise.
Small doses
First, some good news from last night: the case PhRMA brought against the state of Minnesota over the Alec Smith Insulin Affordability Act has been tossed out. This comes after a report last week from the MN Board of Pharmacy in which they claim that the program has helped 465 people get insulin so far. It remains unclear if PhRMA will appeal the case, but for now the law stands.
The American Economic Liberties Project, an anti-monopoly think tank, has launched a campaign called Investigate Insulin Now to get the Federal Trade Commission to tackle the Big Three insulin manufacturers over price fixing. Catch Rep. Katie Porter (D-CA), the Insulin Initiative’s Laura Marston, and others on a panel this Thursday, March 18th.
If that’s not enough excitement for one week, Reps. Pramila Jayapal (D-WA) and Debbie Dingell (D-MI) will be reintroducing Medicare for Allin the House on Wednesday, March 17th.
Reuters reports that Eli Lilly fired an internal whistleblower after she lodged complaints about quality monitoring and safety issues at a New Jersey plant that makes type 2 diabetes drug Trulicity.
Arizona, Connecticut, and Nebraska are among the states who have shifted to age-based rollouts of the COVID-19 vaccine, angering many with diabetes who are at increased risk of severe disease and hospitalization from the virus.
Will smartwatches replace the existing continuous glucose monitors? Apple and Google would like to think so.
Lawmakers in West Virginia want to extend the existing copay caps on insulin for those with state-based insurance plans to apply to other diabetes prescriptions and supplies.
A great piece on Washington’s public generic drug bill featuring WA Insulin4All activist Madi Johnson.
For your ears: Beta Cell Podcast talked about Beyond Type 1’s conflicts of interest, and a new podcast just launched — the Soul of Diabetes, a podcast for BIPOC with diabetes.
—
That’s it for this week’s Shot. As always, my inbox is open. Just reply to this message.
-EP