The Bulletin

Virginia General Assembly caps insulin costs at $50 a month

By: - March 6, 2020 11:10 am

A diabetic girl performs a self-monitored blood glucose test. (CDC Public Health Image Library)

One of the biggest bills of the year is one nobody is talking about, Del. Mike Mullin, D-Newport News, wrote in a tweet on Friday — a hard cap on the price of insulin in Virginia.

Insurers are now limited to charging a maximum of $50 a month for the drug after Del. Lee Carter, D-Manassas, urged colleagues to accept a Senate amendment to his bill. The price is a little higher than his original cap of $30, but still the lowest ceiling for insulin in the country, he said on the House floor.

Insulin prices have tripled over the last decade as the drug’s four main manufacturers have raised the baseline cost. Virginia is the latest state to pass its own controls amid nationwide reports of patients dying after rationing the vital medication.

There have been Congressional hearings over the rising costs, but federal regulators still haven’t settled on a solution to lower prices. Virginia is the third state to pass a law limiting the cost of insulin.

The bill will go to Gov. Ralph Northam for final approval.

“This is aimed at providing relief for folks who have health insurance but still can’t afford their medication,” Carter said during a Senate committee hearing on the bill. “And with Medicaid expansion, that’s going to cover a vast swath of Virginia’s population.”

The legislation prohibits Virginia insurers from setting a patient’s cost-sharing payment for insulin above $50 a month — including deductibles and copays. The bill was supported by the Medical Society of Virginia and the American Association of Retired Persons, but, unsurprisingly, not by the Virginia Association of Health Plans, which argued that the cap on cost-sharing payments would be offset by a rise in premiums.

“If you take a plan that already has a $100 cap on insulin and change it to $50, that other $50 is going to go to premiums,” executive director Doug Gray said after the meeting. “Period. And that’s going to hurt people who are already struggling to afford health care costs.”

Senate lawmakers didn’t appear swayed by Gray’s arguments that many of the state’s health insurers had already capped the cost of insulin. Sen. Adam Ebbin, D-Alexandria, pointed to reports of some patients paying up to $1,200 a month — including a Virginia man who died after switching to a lower-cost and less-effective form of insulin to save for his wedding.

Senate Majority Leader Dick Saslaw, D-Fairfax, said the bill would be accompanied by a letter to the state’s Commissioner of Health, asking for a review of insulin price caps in other states. The legislation is not expected to have an impact on Virginia’s budget, but there’s little long-term data on the effect of statewide insulin caps on insurance prices. Colorado and Illinois, the other two states with similar legislation, passed their laws within the past year. 

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Kate Masters
Kate Masters

Kate grew up in Northern Virginia before moving to the Midwest, earning her degree in journalism from the University of Missouri. She spent a year covering gun violence and public health for The Trace in Boston before joining The Frederick News-Post in Frederick County, Md. Before joining the Mercury in 2020, she covered state and county politics for the Bethesda Beat in Montgomery County, Md. She was named Virginia's outstanding young journalist for 2021 by the Virginia Press Association.