Governor signs 13 health-related bills into law, including one that caps co-payment for insulin at $30/month for an estimated 22,000

Reps. Minter and Bentley, Beshear and interpreter Virginia Moore

By Melissa Patrick

Kentucky Health News

Gov. Andy Beshear signed 13 health bills into law Monday, highlighting one that caps insulin costs for about 30 percent of Kentuckians who need the life-preserving hormone. 

The limit is $30 for a 30-day supply. "This is the right thing to do and it's a game changer for those who rely on insulin to live," Beshear said. "Until now, a single dose of insulin which cost between $2 and $7 to manufacture could sell for an average wholesale price of around $300 per vial."

Beshear noted that in a lawsuit he filed against insulin companies while attorney general over their "unconscionable overpricing," revealed that over 10 years, the price of one insulin product went up 311%, and another rose 285%, including a rise from $325 per package in 2011 to $530 in 2017. 

"While these companies work to increase bottom lines and sustain market shares," he said. "Kentucky families hit hardest by this price gouging can be paying more than $1,000 a month on insulin just to stay alive."

House Bill 95, co-sponsored by Reps. Danny Bentley, R-Russell, and Patti Minter, D-Bowling Green,  will cap the monthly out-of-pocket cost for a 30-day supply of insulin at $30 for Kentuckians covered by state-regulated employer health plans or plans purchased on the marketplace exchange. 

Minter, whose son has Type 1 diabetes, has said the bill will cover about 30% of insulin-dependent Kentuckians. It doesn't cover Medicare, Medicaid or self-funded employer plans except the one for state employees.

"I want to be very clear, this is only a first step," Minter said. "There is much more work to do. . . but today is a very big deal. It will save lives and it will give people hope." She said that for many families, it will make the difference between bankruptcy and keeping a child alive.

In a video, Angela Lautner, Kentucky #insulin4all legislative lead, expressed her gratitude to the lawmakers for the bill, but she too warned that more work needs to be done, saying it will help about 22,000 people. 

"Much more has to be done, but HB 95 is a step forward,” said Lautner, "My chapter is here for insulin for all and that's why we must continue this momentum into the next session with urgency, with priority." 

More than half a million Kentuckians have diabetes, and Kentucky ranks seventh-highest in the U.S. for diabetes prevalence. Lautner said more than one in four insulin-dependent people ration insulin due to cost. 

The price cap will apply regardless of the amount or type of insulin the person with diabetes needs.

In addition to capping the price, HB 95 requires health plans to provide the equipment, supplies and outpatient training and education needed to help diabetics stay healthy, and forbids any reductions from this coverage by others involved in coverage.

The fiscal impact statement attached to the bill says it will increase premiums for health benefit plans, not including the state employee plan, by about 80 cents a month. 

Bentley said that's a small price to pay to make sure diabetics keep getting their insulin, because without it they can suffer amputations, loss of vision, neuropathy, ketoacidosis and even death. "The costs on the medical side is much more than the cost that we're going to have by helping people with insulin," he said. 

Beshear also signed bills addressing these health topics:

Telehealth: HB 140, sponsored by Rep. Deanna Frazier, R-Richmond, will permit telehealth services that were allowed to expand due to the pandemic to remain in place. The bill requires reimbursement for telehealth to be equivalent to reimbursement for the same service provided in person. "I think it's one of the most important bills that have been passed," Beshear said. 

Substance-use disorder: HB 219, sponsored by Bentley, allows pharmacies to sell hypodermic syringes and needles without a prescription. The aim is to increase access to clean supplies for people who inject drugs, which will help to decrease the risk of blood-borne diseases such as hepatitis C and HIV/AIDS.

Medicaid and hospitals: SB 55, sponsored by Sen. Stephen Meredith, R-Leitchfield, abolishes co-payments required by Medicaid.

HB 183, sponsored by Rep. Brandon Reed, R- Hodgenville, will allow Kentucky hospitals to get more money from Medicaid, based on an "average commercial rate" instead of the current Medicaid rate, which is often below that amount. The program would not cost the state anything, because Kentucky's hospitals have agreed to cover the cost. To get the money, hospitals will have to abide by higher quality standards that are still being decided by the Kentucky Hospital Association and the Cabinet for Health and Family Services. The bill is expected to help many of the state's rural hospitals; a recent report shows that 16 of them are at risk of closing. 

Colon cancer and genetic testing: HB 108, sponsored by Melinda Gibbons Prunty, R-Belton (Muhlenberg County), codifies current Medicaid coverage of colorectal cancer, including screenings starting at 45 for most people and genetic cancer-risk testing, to align Medicaid and commercial coverage.

Mental health parity: HB 50, sponsored by Rep. Kim Moser, R-Taylor Mill, will make health-insurance plans comply with a 2008 federal law that requires them to treat mental-health conditions and substance-use disorders the same as physical health. It also requires health insurers to file annual reports with the state to show how they are complying with the federal law.

Workforce: HB 276, sponsored by Moser, allows Kentuckians trained as temporary Covid-19 personal-care attendants under an executive order to apply their supervised training toward their Registered Nurse Aide certification. About 300 personal-care attendants work in Kentucky long-term care facilities, Moser said while presenting the bill to the House in February.

SB 154, by Sen. Tom Buford, R-Nicholasville, lets advanced practice registered nurses and physician assistants prescribe and supervise home-health services, as federal law has allowed them to do in the pandemic. An emergency clause ensures there would be no gap in care if the federal rule ended.

HB 448, sponsored by Rep. Bill Wesley, R-Ravenna, expands the definition of "qualified mental-health professional" so that it fits the state's juvenile code, allowing those who work in private agencies to testify in child-welfare hearings, especially around issues of emotional injury.

Alzheimer's Disease: SB 74, by Sen. Ralph Alvarado, R-Winchester, creates but does not not fund a dementia services coordinator in the heath cabinet to manage the Alzheimer’s Disease and Related Disorders Council, the state plan to address Alzheimer’s in Kentucky, and apply for federal funding.

Living organ donors: HB 75, sponsored by Rep. Shawn McPherson, R-Scottsville, prohibits insurance companies from increasing rates on organ donors or dropping their coverage. It would also encourage the cabinet to develop educational materials relating to organ donation.

Charitable care: SB 163, sponsored by Sen. Alice Forgy Kerr, R-Lexington, expands the definition of "charitable health care provider" to include those that provide invasive or surgical procedures. This change was needed to allow the non-profit surgery program "Surgery on Sunday" in Lexington to be reimbursed for liability insurance premiums. 

 
Beshear also vetoed five bills that would strip power from the governor or the executive branch. None were related to health.