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Ohio Bill Would Cap Out Of Pocket Cost For Insulin

Judith Garcia, 19, fills a syringe as she prepares to give herself an injection of insulin at her home in the Los Angeles suburb of Commerce, Calif.
Reed Saxon
/
AP
Judith Garcia, 19, fills a syringe as she prepares to give herself an injection of insulin at her home in the Los Angeles suburb of Commerce, Calif.

Diabetics who depend on insulin to live often find themselves paying hundreds, sometimes more than $1,000 a month, for that medication. A new bill would limit that out of pocket cost to $100 for a one month supply.

The bill is sponsored by Democrats in the Ohio House and Senate. Dr. Beth Liston, one of the sponsors, says she's seen many patients who have rationed insulin and faced serious life-threatening illnesses as a result. She says limiting the amount that patients would pay would save lives and money.

Antroinette Worsham of Cincinnati backs the bill. Her 22-year-old daughter died as a result of insulin rationing after she turned 21 and aged off the Ohio Bureau for Children with Medical Handicaps program.

Worsham says the out of pocket costs for her daughter's insulin and diabetic supplies were more than $1,000 per month. And even though Worsham was working and had a good job, she couldn't qualify for financial assistance through programs offered by drug manufacturers.

Worsham and other advocates for diabetics point out insulin can be obtained in Mexico and Canada at a fraction of the price charged in the United States. They say some people are traveling out of the country to get the drug.

Gary Doughtery is the director of state government affairs for the American Diabetes Association. He says insulin affordability is a matter of life or death. He says more than 4.3 million Ohioans either have or are at risk of diabetes. And he says one in four insulin users ration insulin because they cannot afford the medication.

The Ohio bill is modeled after a new program in Colorado. It places a $100 per month cap on insulin co-pays. Insurance companies are required to pay anything above that amount. That law also enlists the Colorado attorney general to investigate price gouging.

Liston says she has spoken with the Ohio Attorney General's office about that part of her bill and has made changes to language to make sure that part of the legislation is workable. Liston says she's also talking with Republicans in the Ohio Legislature to get them on board as well.

Still, Worsham is worried she could lose another child because of high insulin prices. Her younger daughter, who is also insulin dependent, will go off the Ohio Bureau for Children with Medical Handicaps program soon. And when that happens, Worsham hopes this bill will be in place so the insulin will be more affordable.

Jo Ingles is a professional journalist who covers politics and Ohio government for the Ohio Public Radio and Television for the Ohio Public Radio and Television Statehouse News Bureau. She reports on issues of importance to Ohioans including education, legislation, politics, and life and death issues such as capital punishment.
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