MINNEAPOLIS — Make no mistake about it. Sen. Scott Jensen says he wants to see an emergency insulin bill, and he'd rather see it done in a special session rather than wait until 2020.
In fact, he was one of the co-authors of Sen. Melissa Wiklund's bill, the Alec Smith Emergency Insulin Act, in the 2019 session.
But the Chaska Republican, who is also a physician, couldn't bring himself to vote for the last-ditch effort to save the Alec Smith Emergency Insulin Act in the waning hours of the special session last month.
For starters, Sen. Wiklund was trying to put it into the final Health and Human Services bill as a floor amendment. Majority leaders in both the House and Senate had already both warned members against attempting any floor amendments, because they were racing to pass all budget bills in a single 24-hour session.
"So, for one, we we’re told no. And then, for second, I read the amendment and said, 'This isn’t what I signed on for in January. This has been totally redone!" Sen. Jensen told KARE.
After some lengthy discussions at 3:00 a.m. the amendment failed on a vote of 34 to 33. Jensen joined 33 other Republicans to vote against it, while all 32 Democrats and Republican Carla Nelson voted in favor.
It was puzzling to many supporters of the idea, because the Senate had passed adopted similar language in the original HHS bill on April 30.
Jensen said any emergency insulin plan needed to have a sustainable, reliable source of funding and a network of pharmacists willing to provide those emergency supplies.
He worried the version being debated at 3:00 a.m. would encounter legal issues because it called for a fee on insulin manufacturers but left out wholesalers and distributors.
"What I’ve read, studied and as a physician in the trenches for 35 years, I don’t think the manufacturers are going to go quietly in the night and pony up. I think it would end up in court," Jensen explained.
"You’ve got a supply chain that’s fairly elaborate, in the world of pharmaceuticals, and you pick one link and say you’re going to foot the bill here."
His roughly estimates the price tag for the program at $15 million per year, but didn't think the last-ditch version of the Alec Smith Bill could generate that kind of money through fees on manufacturers alone.
Jensen would rather see the money come from the state's Health Care Access Fund, which is paid for with a 1.8 percent fee on medical providers.
"We have to ask ourselves what is the health care access fund, if not a fund to insure access? Seems to me the name of the fund says this would not be a bad place to go for dollars," Jensen remarked.
"Could we supplement that with some registration fees for insulin from manufacturers and distributors, and PBMs? Sure, we could!"
Virtually everyone involved with the Alec Smith Emergency Insulin Act were frustrated it didn't get put in the final HHS bill during the conference committee process. But there's no clear explanation of why it fell to the wayside.
Sen. Wiklund said the main difference between the Senate's April 30 bill and the one that passed the House was how much of a supply people would get -- 30 days in the Senate bill, versus 90 days in the House's. The House version also provided more generous benefits because it applied to the under insured, or people with high out-of-pocket deductibles.
Only the DFL-controlled House held committee hearings on the bill during the regular session, and only the House debated and passed the Alec Smith bill on the floor.
In the GOP-controlled Senate, HHS Chair Michelle Benson never granted the Alec Smith bill a committee hearing.
"The chair decided not to hear it. So, when we don’t get to hear it in committee, then we don’t get to ask the questions. We don’t get to slice and dice it out, ask the experts," Jensen lamented.
The legislature did pass a bill regulating Pharmacy Benefit Managers, or PBMs, for the first time. Jensen hopes that will bring more transparency to pricing structures, and help lawmakers decide how best to tackle the pricing issue.
Jensen said it would be best if the Special Session was done solely for the purpose of an insulin bill, rather than revisiting other legislation or using the insulin measure as a bargaining chip for other, unrelated measures.