ST PAUL — After a year of negotiations and a final hour of debate on the floor, the Minnesota House passed its insulin affordability bill by a 75-52 vote on Wednesday, Feb. 26.

And it still may not clear the Republican-controlled Senate to reach Gov. Tim Walz's desk.

House Democrats' House File 3100 establishes both emergency and long-term programs for diabetic Minnesotans struggling to afford their insulin in light of the drug's skyrocketing price in recent years. Democrats in January touted it as a compromise between Democratic and Republican ideas, but Republicans still have concerns with it.

At Wednesday's debate, those partisan differences came to a head: House Republicans stood firm in their belief that the government shouldn't have its hands in an insulin affordability program, but it should be left to pharmaceutical and insurance companies to hash out. Democrats' retorted that if manufacturers and suppliers were taking that initiative, Minnesotans wouldn't be coming to the Capitol asking for the state to step in — or in some cases, dying.

"Insulin isn't a life-saving drug. It's life-necessary. It's necessary to live," said primary author Rep. Michael Howard, D-Richfield, on the floor. "(HF 3100) will create a true safety net for Minnesotans so never again will we hear about someone dying because they couldn't afford the insulin they needed to survive."

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Some varieties of insulin have tripled in price over the past decade. As of Feb. 13, a spokesperson for Eli Lilly — one of three manufacturers of insulin — told Forum News Service that the list price of one vial of Eli Lilly's most commonly used insulin is $275.

Minority Leader Rep. Kurt Daudt, R-Crown, on the floor doubted whether anyone "actually" pays upward of $300 for a bottle of insulin, pointing to manufacturers' coupons and rebates to make the drug more affordable. But he agreed that the rising cost of insulin is a problem — just not one that the Legislature should try its hand at solving.

"We all want to solve this, but government is not equipped to solve this problem," he said. "Why? Because we created it with this pricing scheme."

He continued to call the bill "a government solution to a problem that really is going to make it worse," saying that if the Legislature imposes fees on insulin manufacturers to fund the program, they'll in turn raise insulin prices higher to compensate.

"We're passing a bill that actually raises the cost of insulin and then certain people are going to get it for free," he said.

Rep. Jeremy Munson, R-Lake Crystal, also questioned the role of the government in the insulin issue, saying that the bill has progressively gotten "larger and larger in scope," and called it "a foot in the door for a complete socialist takeover of health care."

He went one step further to question, "Why diabetics?"

"Why are diabetics getting everything for free, or nearly free, when we have so many prescription drugs, hundreds of drugs, hundreds of procedures, out of reach for so many Minnesotans?" he asked. "Is it because diabetics have the best lobbying groups out there?"

The debate escalated when Rep. Alice Mann, D-Lakeville, who works as a physician, shot back at Munson: "I ask you to spend one day in the shoes of a diabetic and tell me how great their lives are, and how great it is that they get stuff for free."

"Every single thing they do, every single minute of their day, is dictated by, 'What is my sugar right now,' " she continued. "They're not getting anything for free."

Rep. Laurie Halverson, D-Eagan, said on the floor that she, herself has Type 1 diabetes. For her and others with Type 1, she said insulin "really is like air," and paying hundreds of dollars per vial "would be like if you were being charged to breathe air."

"There are people sitting on our Supreme Court who have diabetes and there are race car drivers with Type 1 diabetes, and professional athletes and rock stars like Bret Michaels have Type 1 diabetes," she said. "You can be a hero with Type 1 diabetes, but it doesn't mean that the load is easy to carry and it doesn't mean we don't walk around with fear for what this disease could do to our lives."

According to the state Department of Health, approximately 330,000 Minnesotans have been diagnosed with Type 1 or Type 2 diabetes, and roughly 18,000 new cases are diagnosed annually.

Democrats' bill is named after Alec Smith, a Minnesotan who died in 2017 at age 26 when he could not afford his insulin. The bill now progresses to the Minnesota Senate.