SPRINGFIELD — A cap on prescription insulin costs for some health insurance plans is headed to Gov. J.B. Pritzker, who said on Nov. 14 he looks forward to signing the measure.
Supporters of the bill gathered at the Illinois State Capitol on Nov. 14 to celebrate the passage of Senate Bill 667 and make clear the legislation was only part of a larger effort to hold prescription drug manufacturers and insurance companies accountable.
“It’s time to fix this broken system. It’s time to stop the tweaks. It’s time to stop the half measures. It’s time to stop passing the buck. That will not lower drug prices,” said William McNary, co-director of Citizen Action Illinois. “We need policies that will hold drug companies accountable and make medicines affordable and to take away the corporation’s power to put profits over people’s health.”
McNary said drug companies have artificially run up the price of insulin.
The bill will not affect the price drug manufacturers set for insulin, however. Rather, it caps, at $100, the out-of-pocket price insurers can charge for the drug for those who have insurance regulated by the state. This includes those purchasing their insurance on the marketplace, and state employee insurance plans, among others. The bill takes effect in January 2021.
The bill’s House sponsor, Rep. Will Guzzardi, D-Chicago, said it would not apply to plans offered by large employers governed by the federal Employee Retirement Income Security Act because the state cannot preempt federal law.
It is estimated to affect approximately 20 percent, or 260,000, of the state’s 1.3 million insulin users.
While McNary called the Illinois bill a “significant step,” he said federal action is still needed to address rising prescription drug prices across the board, and Guzzardi agreed.
His bill passed with significant bipartisan majorities in each chamber, as representatives of the prescription drug and insurance industries listed themselves as “neutral” on the measure.
Guzzardi said he negotiated amendments to the bill to bring industry groups to a point of neutrality in order to strengthen the roll call.
One of those concessions was including an annual increase to the $100 price cap at the same rate of the medical care component of the Consumer Price Index of the U.S. Bureau of Labor Statistics.
The amendment also removes “intravenous” insulin from the cap and shifts the responsibility of creating a report on the cause of rising insulin prices to the Illinois Department of Insurance from the Illinois Attorney General’s Office.
Guzzardi also said that, beyond the amendments, public pressure helped get the industry advocates to a neutral position.
“They knew that this was coming. And they saw the power and the movement behind this bill, and they realized that it was not going to be a good look to stand in its way,” Guzzardi said. “That’s how we beat them on this issue. And that’s how we’re going to beat them on all the issues to come.”
In floor debate Wednesday, however, Rep. Deanne Mazzochi, R-Elmhurst, said industry groups were neutral because they knew they could continue to rake in profits by shifting costs to other areas such as premiums and deductibles.
“The reason industry players are neutral on this bill is because they know it’s really not going to cut costs, it’s going to make a redistribution of costs,” she said. “It’s going to shift them from one player to the other, but the players are still going to get paid.”
Pritzker, a Democrat, has been advocating for the measure for the past month and released a statement declaring his intent to sign the bill.
“It’s fitting that on World Diabetes Day, Illinois has taken bold action to protect our residents’ health, rather than force them to use lower quality medication or even ration their supply,” the governor said in a statement. “We are proud that Illinois continues to be a national leader in ensuring health care is a right and not a privilege. … I look forward to signing this legislation and continuing my commitment to ensuring Illinois residents have access to comprehensive, high-quality and affordable health care coverage.”