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New Ky. Law Caps Insulin Co-Pay at $30 for 30-Day Supply

This article has been corrected to include the presence of Christ Hospital Diabetes and Endocrine Center in Ft. Wright.

The soaring price of insulin has been a constant problem for insulin-dependent diabetics. Under President Joe Biden's Build Back Better Plan, he seeks to cap monthly insulin co-pay at $35. But Kentucky lawmakers are ahead of the curve. 

On Jan. 1, a new law went into effect in Kentucky that caps insulin co-pays at $30 for a 30-day supply. The plan works for all private insurance plans in Kentucky, except for Medicaid or Medicare, which are federal plans. 

"Even with insurance, I heard from constituents that it was still very, very expensive," said bill co-sponsor Rep. Kim Banta (R-Ft. Mitchell) regarding the price of insulin. She noted that one person she talked to paid roughly $125 a week with insurance. 

For Northern Kentucky resident David Brooks, insulin has been a lifeline since he was a kid. Like most type-1 diabetics, Brooks's diagnosis story is frightening. He started having symptoms that involved intense thirst, which wasn't a big deal at first because he could drink more of his favorite soda, Surge. This led to more frequent urination, and finally, he mentioned it to his mom.

Brooks eventually started getting weak and couldn't play games with his sisters. He went to school the next day but couldn't make it through the day. His mom took him to a doctor and had his blood sugar checked but it was too high to register, so he had to go to the hospital where his blood sugar registered over 1,000 mg/dL. 

"As a type-1 diabetic, this law is really a sigh of relief as I can't tell you how much my family and I have spent on insulin alone," Brooks said. "The prices have skyrocketed since 1997 when I was first diagnosed, and it's really unfair as this drug is literally required for me to live." 

The bill proposal for the new law came to fruition in 2020 when three insulin-dependent House members, including Rep. Danny Bentley (R-Russell) and former Rep. Charles Booker (D-Louisville), decided that a life-saving medicine shouldn't be out of reach for patients. Patients who can't afford the drug often have to ration insulin, which leads to dangerous health consequences, such as Diabetic Ketoacidosis. 

"There are cases of people who died for those who rationed their insulin due to price," Brooks said. "I have been fortunate with the people in my life that I could afford it with insurance, but I have a high deductible plan, so it's still a large cost for insulin most of the year." 

Banta heard stories that families had to make the difficult choice of eating or buying insulin for their child in some situations. It didn't seem right to her, especially since the medicine is cheap to manufacture. Other local sponsors include Buddy Wheatley (D-Covington), Rachel Roberts (D-Newport), Joe Fischer (R-Ft. Thomas), and Ed Massey (R-Hebron). 

"I think it means you're going to be able to afford your life-saving medication," Banta said of the new law. "It's not going to take such a huge bite out of your budget." 

"Thousands of Kentucky families will benefit from this bill, and lives will be saved as folks no longer have to ration their insulin because they cannot afford co-pays," Roberts said. 

There are an estimated 475 thousand Kentuckians that live with diabetes, according to statistics from the Cabinet of Health and Family Services. Type-2 is the most common and caused by lifestyle factors and genetics leading to insulin resistance. It is treated with oral medication, but some patients require insulin. Type-1 is an autoimmune disease where the pancreas doesn't produce insulin, so patients rely on insulin to live. 

Locally, Northern Kentucky has a 14.6 percent prevalence of diabetes, which is above the 13.7 percent state average and the national average of 10.6. To tackle this large number, there are Christ Hospital Diabetes and Endocrine Center in Ft. Wright, and Covington is home to the St. Elizabeth Diabetes and Endocrinology Center.

"We are going to continue to work on this this session to bring more insurers in and cover even more Kentuckians," Roberts said. 

Written by Mark Payne, LINK Media politics and government reporter. Mark Payne is spending the 2022 Kentucky General Assembly session in Frankfort covering it for Northern Kentucky.