Delegate Jim Butler, R-Mason (left) listens to remarks by Delegate Shawn Fluharty, D-Ohio, during a debate Friday in the House of Delegates over a bill that caps insurance copays for insulin at $35 per 30-day supply.
West Virginians would pay no more than $35 for a 30-day supply of insulin under a bill approved Friday by the House of Delegates.
Senate Bill 577 affects insulin copay rates for private insurance, Medicaid and the Public Employees Insurance Agency by placing a cap on out-of-pocket costs for insulin and related devices. It reduces the current copay for insulin from $100 to $35 for a 30-day supply and would set the copay for insulin-related devices at $100 for a month’s supply.
The bill has already cleared the Senate and was approved, with amendments, in the House of Delegates on a vote of 85-12 with three delegates absent. It will go back to the Senate for a second look.
During Friday’s House floor session, supporters said the bill was a message to insurance and drug companies to keep costs reasonable. Opponents argued that the legislation will cause insurance companies to shift copay losses to other policyholders.
Delegate Jim Butler, R-Mason, was one of the 12 delegates who voted against the bill. He argued that the drug company Eli Lilly has already reduced the cost of its insulin and others are likely to follow suit.
“I certainly see the intent of this, and I think it’s a great intent. I don’t know if it’s really necessary. The free market is already working. These drugs are already being reduced because of that,” Butler said. “What I’m concerned about is ... it’s going to shift the cost to others who are buying into these insurance plans. And, in some cases, it causes people not to be able to afford the insurance they otherwise had.”
Delegate Laura Kimble, R-Harrison, said she could not support the increased premiums she believes will result if the bill is signed into law.
“All we’re doing is cost-shifting for private insurance companies,” Kimble said. “Private insurance will see a cap, it’s true. They’ll go from $100 to $35, but someone else will be paying the difference. There will be a butterfly effect for some and a tyrannosaurus rex effect for others.”
Other opponents of the bill said they were voting against government interference in the free market.
It would be easy to vote for the bill “because it tugs on people’s heart strings,” Larry Kump, R-Berkeley, said. He added that he is against the bill even though he is a diabetic.
“From my education as an economics concentration in college, and my personal experience, I really don’t think government price controls or wage controls work. In fact, I think they make things worse,” he said. “I have to, on principle, vote no on this bill.”
Elias Coop-Gonzalez, R-Randolph, expressed similar concerns.
“Price controls never work. I appreciate the intention of this bill, but I think it will end up doing the opposite of what it intends to,” he said. “I agree that insulin prices are too high and there are things that we can do about it. We should do something about it. But I don’t think central planning is an answer to that.”
Speaking in support of the bill, Joe Ellington, R-Mercer, said insulin costs without insurance can easily run into the hundreds of dollars.
“My son is a Type 1 diabetic, so he needs insulin to live. He ran out of his insulin a week before his renewal prescription from PEIA. So, instead of him paying his $50 copay, they charged him $600, just so he could get by that next week,” Ellington said. “It’s ridiculous for someone trying to survive to go and have to pay $600 just to get their medication for the next day.”
Other supporters of the bill, including Delegate Shawn Fluharty, D-Ohio, said they believe it would put pressure on pharmaceutical companies to keep prices low.
“What are we doing? I can’t believe people are getting up on this House floor and arguing that Big Pharma needs more money,” Fluharty said. “Our state has been ravaged by Big Pharma, and we’re going to argue that they need more money?”
Delegate Ric Griffith, D-Wayne, also supported the legislation, saying people who need medication often have to make tough decisions while insurance and pharmaceutical companies make profits.
“We often hear, ‘Do I buy food or do I buy my medicines?’ One of the things that I think you need to realize is, the insurance companies and the pharmacies across this country are doing very well, very well indeed,” Griffith said. “What this bill is trying to do is the start of a process to put pressure on these companies to not overcharge. We’re trying to do something to help the financial burden on these people. Drug companies will continue to make a huge profit.”
Roger Adkins covers politics. He can be reached at 304-348-4814 or email firstname.lastname@example.org. Follow @RadkinsWV on Twitter.