Lori P., a Floridian who has lived with diabetes for more than 40 years, understands the serious consequences of failing to properly treat her diabetes, as the disease caused her to have four miscarriages and two scary trips to the emergency room. Still, escalating insulin prices force Lori to buy Walmart-brand insulin instead of the specialized insulin prescribed by her doctor.
Alongside Lori, an estimated 2.4 million people have diabetes in Florida, with more than 100,000 Floridians diagnosed each year. Floridians with diagnosed diabetes incur significant medical costs on physician office visits, hospital inpatient care and insulin that adds up to more than $9,000 in annual costs, according to the American Diabetes Association. Like Lori, uninsured Floridians must spend even more out-of-pocket to treat diabetes, as 68 percent of uninsured Floridians pay the full price for insulin compared to just 9 percent of privately insured Floridians. These statistics highlight the urgent need to alter the affordability of diabetes-related medical costs in Florida.
To address the rising insulin costs for uninsured and low-income Floridians, D-Sen Janet Cruz has introduced Senate Bill 786, which would cap the cost of insulin at $100 per month. The Senate Banking and Insurance committee voted 12-0 in favor for this bill, which is now in Appropriations Subcommittee on Health and Human Services. While capping the monthly cost of insulin represents a step in the right direction, the American Diabetes Association estimates that insulin comprises just 45 percent of the annual costs associated with treating diabetes. Although SB786 would provide some financial relief and improve access to insulin, it is a temporary solution to the rising medical costs associated with diabetes. Furthermore, as the legislature is scheduled to adjourn at the end of April 2021 and the House companion bill has yet to schedule its next committee hearing, this bill is highly unlikely to pass.
The solution: Medicaid expansion
While Medicaid Expansion may also be unlikely to pass through the legislature, expansion offers the most comprehensive solution to address the rising costs of insulin and other medical treatment for low-income, uninsured Floridians. In one legislative stroke, Medicaid expansion would reduce costs for physician visits, hospital care, medication and more. Expansion represents a single solution that would provide low-income and uninsured diabetic Floridians with greater access to affordable physician care and insulin while also saving the state money. The federal government covers 90 percent of the cost for beneficiaries of Medicaid expansion, so states that expand Medicaid will save between 15 and 40 cents on every dollar of medical care with expansion. Studies show that Medicaid expansion has led to an increase in filled insulin prescriptions and more timely and effective treatment of diabetes, offsetting future medical costs associated with diabetes. The consequences of not expanding Medicaid have already affected Floridians and the state’s budget alike: an additional 1,360,000 Floridians would receive coverage through Medicaid expansion and the state is projected to lose $66 billion in Medicaid funding by 2024. Thus, Medicaid expansion offers Florida a fiscally responsible approach to minimizing the rising costs associated with diabetes while providing sufficient medical care to all Floridians with diabetes.
What Can You Do?
By sharing her story with Florida Voices for Health, Lori P highlighted Florida’s dire problem of unaffordable insulin prices. These stories lie at the heart of the Florida Voices for Health and the Health Care for Florida coalition, who are actively engaging inleading a campaign to expand Medicaid and alleviate costs associated with diabetes-related medical care. Floridians like you can help our fight for Medicaid expansion by sharing your healthcare story or a loved one’s healthcare experience by emailing FLVoices@healthyfla.org. In addition, you can advance our campaign through two simple tasks:
· Recruiting family, friends and co-workers to sign our petition by visiting www.healthcareforfl.org or texting MEDEX4FL to 52886
· Contacting your local legislators with one click of the mouse at https://www.healthcareforfl.org/action
Cohen, Joshua. (2021) Insulin’s Out-Of-Pocket Cost Burden To Diabetic Patients Continues To Rise Despite Reduced Net Costs To PBMs. Retrieved from: https://www.forbes.com/sites/joshuacohen/2021/01/05/insulins-out-of-pocket-cost-burden-to-diabetic-patients-continues-to-rise-despite-reduced-net-costs-to-pbms/?sh=4c6f278340b2
The Cost of Diabetes. Retrieved from: https://www.diabetes.org/resources/statistics/cost-diabetes
Alonzo-Zaldivar, Richard. (2020) Most Medicare enrollees could get insulin for $35 a month. Retrieved from: https://www.sun-sentinel.com/news/politics/fl-ne-ap-insulin-price-drop-20200527-cmbxupvzhfdgje43siowo4rfqq-story.html