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Pritzker signs bill to cap some out-of-pocket insurance costs for insulin

Monday, Jan 27, 2020

* Tribune

Illinois became one of the first states in the U.S. to limit the out-of-pocket price of insulin when Gov. J.B. Pritzker signed a measure on Friday that caps the cost of medication people with diabetes rely on.

Sen. Andy Manar, the downstate Democrat who sponsored the bill that caps the out-of-pocket cost for insulin at $100 for a 30-day supply regardless of how much is needed to fill a patient’s prescription, called it the “biggest step that we can take under Illinois law.” The law takes effect Jan. 1. […]

Illinois’ price cap applies to state-regulated commercial insurance plans but does not touch federally regulated plans. In his push for the state insulin cap, Manar has advocated for similar action at the federal level.

“We should take this and we should celebrate this victory when the governor signs this bill,” Manar said. “And then we should keep going, because we have so much more to do when it comes to the affordability of prescription drugs.”

* Capitol News Illinois

With the signing of SB 667, Illinois became only the third state to cap out-of-pocket insulin prices. The law applies to people who are covered by health plans subject to state regulation. That includes most kinds of private insurance, the state Medicaid plan and the state employees’ health plan.

It does not, however, apply to self-insured plans, which many large companies with thousands of employees offer. Those plans are regulated under federal law.

The law also does not limit what prices insulin manufacturers are allowed to charge for the medication. It controls only how much of an out-of-pocket cost insurers can require patients to pay, essentially shifting a greater share of the cost onto insurance companies.

“I think one thing that we’ve all recognized in this process is there are an awful lot of middlemen that have caused a spike in the price and they need to work out among themselves how they’re going to deal with that change,” Pritzker said.

* Center Square

At the bill signing, state Sen. Andy Manar, D-Bunker Hill, said the actual number of Illinoisans with diabetes who will be benefit wasn’t known.

“That’s an open number,” Manar said. “So, I would describe it as this bill, now the law, is the biggest step we can take under Illinois law. Self-insurance programs are insurance programs that are not covered. Those are federally regulated.”

State Rep. Tom Demmer, R-Springfield, previously estimated Illinois regulations on insurance only affect 20 percent of the industry.

“So when you see a story that says ‘this kind of coverage is now required, the insurance to cover X, Y and Z in Illinois’ or there’s a restriction placed on something, that only applies to plans that are licensed and regulated by the [Illinois] Department of Insurance,” Demmer said.

Something, as they say, is better than nothing.

- Posted by Rich Miller        

7 Comments
  1. - Demoralized - Monday, Jan 27, 20 @ 10:48 am:

    Yes, something is definitely better than nothing. And it’s about time that someone stood up to the drug companies on issues like this and told them enough is enough. We need more of this sort of action to protect the consumer from outrageous increases in drug prices, especially for medications that are common, such as insulin.


  2. - Bruce (no not him) - Monday, Jan 27, 20 @ 11:13 am:

    I think this bill is an important first step. But…” Andy Manar, D-Bunker Hill, said the actual number of Illinoisans with diabetes who will be benefit wasn’t known.” I have a bad feeling that the reason the number isn’t known, is because it is a pretty low percentage. And doesn’t fit the narrative that they wish to show.


  3. - Grandson of Man - Monday, Jan 27, 20 @ 11:21 am:

    Another great bill by Sen. Manar.

    Since many major policies were enacted last year, maybe this year and beyond should have more health insurance reform, like a public option. We have to make it a point that American uninsured rates are unacceptable (with Texas having the worst rate). Most if not all other major economic countries already solved this problem or greatly reduced it.


  4. - don the legend - Monday, Jan 27, 20 @ 11:46 am:

    ==State Rep. Tom Demmer, R-Springfield,==

    Not sure where he represents, but it’s not Springfield


  5. - low level - Monday, Jan 27, 20 @ 12:15 pm:

    As a type 1, insulin dependent diabetic myself, I am very grateful to Sen Manar and Governor Pritzker


  6. - Looking down the Road - Monday, Jan 27, 20 @ 5:04 pm:

    “…they need to work out among themselves how they’re going to deal with that change.”

    Duh … The cost will be spread out over all insured.


  7. - Oswego Willy - Monday, Jan 27, 20 @ 9:39 pm:

    This is really a great law.

    It’s life saving medicine that has a price inflated beyond its scarcity.


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