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House Approves $35 Insulin Co-Pay Cap

The West Virginia Legislature once again took up the issue of insulin costs with legislation passing the House to cap insulin co-pays for patients at $35 for a 30-day supply.

House Health Committee Chair Del. Amy Summers, R-Taylor, said the bill addresses the high cost of treating diabetes in the state, which has a high rate of the disease.

“This bill addresses insulin because we have a very high diabetic population in West Virginia that is costing a lot of money to treat those people,” Summers said. “So we want to be able to allow them to get the medicine they need at a reasonable price and keep their disease process under control.”

Senate Bill 577 aims to reduce the co-pay cap on insulin and devices and permit the purchase of testing equipment without a prescription. It faced debate on the House floor from legislators arguing for a free market, though drug maker Eli Lilly voluntarily capped the insulin it makes at $35. The federal Inflation Reduction Act last year capped insulin at $35 for Medicare recipients.

Among over 20 delegates who rose to speak to the bill, was Del. Laura Kimble, R-Harrison, who questioned Summers about including other life-saving medications in the bill.

“The reason for me voting red on this bill was quite simple. All we’re doing is cost-shifting for private insurance companies. Private insurance, we’ll see a cap. It’s true, they’ll go from $100 to $35. But someone else will be paying the difference,” Kimble said. “That will be shifted, there will be people, there will be a butterfly effect for some and there will be a Tyrannosaurus Rex effect for others. Whether through increases in premiums, medicines, employers, for employers or employees, someone will be asked to pay more. Nothing comes without a price.”

The debate continued with Democratic colleagues, Dels. Shawn Fluharty, D-Ohio, and Ric Griffith, D-Wayne both rising to speak in passionate support of Senate Bill 577.

“Imagine being from West Virginia, and arguing that big pharma needs more money,” Fluharty said. “What are we doing? I can’t believe people are standing up on this House floor and arguing that big pharma needs more money.”

“Every day across our state. People who need medications make very tough decisions,” Griffith said. “We often hear the comparison of do I buy food? Or do I buy my medicine? Well, one of the things I think you need to realize is the insurance companies and the pharmacies across this country are doing very well. Very well. Indeed.”

Del. Adam Vance, R-Wyoming, asked some questions on the House floor and then spoke in support of Senate Bill 577 calling it a win for West Virginians.

“I know what everybody’s wanting to do, and I get it from both sides and all that. But to me, this is just a win. I mean, if they can raise the premiums without capping it, your money is gonna go up anyway – people will go off of it anyway. But if we can help out somebody, and I know, we want to help everybody, and maybe we can work on that later. But if we can help out somebody now, and if the premiums go up, they go up, but they can go up even without doing,” Vance said. “And I hate to speak against some of my friends and colleagues. But I’m going to support this bill just for the simple fact that there’s no guarantee that the rates don’t rise without doing it. So if we can help out one group doing it, we might as well do it.”

Before a vote was called, Summers said it’s time that lawmakers consider what’s best for the people of the state and help them as they need.

“I’ve listened to all the debate here today. And I understand this is a policy decision. I used to be a purist as well, where no price controls, that’s not the Republican thing to do. That’s not the capitalist thing to do,” Summers said. “But over the years, I’ve softened a bit as I’ve thought through how do these government policies, how do these companies, these drug companies, these insurance companies, how do they impact the citizens in my district, the citizens in West Virginia, drug companies and insurance companies I feel may be taking advantage of our people.”

Senate Bill 577 passed the House of Delegates with 85 yes votes, 12 no votes and 3 not voting or absent. It now returns to the Senate to review its House amendments.

Lawmakers Discuss Flooding Challenges And Goals

On this episode of The Legislature Today, heavy rainfall late last week prompted Gov. Jim Justice to declare a state of emergency for all 55 counties in West Virginia. Flooding is common in West Virginia and Assistant News Director Caroline MacGregor brings us this perspective on the problem.

On this episode of The Legislature Today, heavy rainfall late last week prompted Gov. Jim Justice to declare a state of emergency for all 55 counties in West Virginia. Flooding is common in West Virginia and Assistant News Director Caroline MacGregor brings us this perspective on the problem.

And to discuss what the state legislature can do about it, MacGregor sits down with the Co-Chair of the Joint Legislative Oversight Commission on State Water Resources Del. Clay Riley, R-Harrison, and the Co-Chair of the Joint Legislative Committee on Flooding Sen. Chandler Swope, R-Mercer.

Also, a public hearing is set for Friday on a bill relating to forbidding government limitations on the exercise of religion. The contentious proposal failed in 2016. Randy Yohe reports on the debate.

Finally, the Senate passed five bills Thursday related to elections in the state, as well as issues around diabetes. Chris Schulz has this story.

Having trouble viewing the video below? Click here to watch it on YouTube.

The Legislature Today is West Virginia’s only television/radio simulcast devoted to covering the state’s 60-day regular legislative session.

Watch or listen to new episodes Monday through Friday at 6 p.m. on West Virginia Public Broadcasting.

Senate Passes Bills On Elections, Cost Of Insulin

The Senate passed five bills Thursday related to elections in the state, as well as issues around diabetes.

The West Virginia Senate passed three bills Thursday related to elections in the state.

All three bills originated from the Secretary of State’s office as technical cleanups.

Senate Bill 620 makes just four changes to state code that would increase the maximum number of registered voters per precinct, as well as the distance between polling places.

Sen. Charles Trump, R-Morgan, chair of the Senate Judiciary Committee and the bill’s lead sponsor, said the bill increases the maximum number of voters in an urban precinct from 1,500 to 2,500, and allows for greater consolidation of precincts.

“There’s also authority under this bill for counties, county governments, county commissions to consolidate precincts. But there are limitations on the geographical distance,” Trump said. “The consolidated precinct cannot contain more than 5,000 total – that’s up from 3,000 registered voters – and under existing law, there’s a one mile radius limit. This would expand that to five miles. It’s all permissive. It would be up to the county commissions to decide whether or not to do that when they exercise the statutory authority of drawing and configuring the voting precincts in their respective counties.”

During discussion of the bill in the Senate Judiciary Committee on Feb. 17, Sen. Mike Caputo, D-Marion, expressed concern that the consolidation of polling places the bill allows would create undue burdens on voters.

“I think it’s our job to make voting easier for our constituents, not to add what I think could be a cumbersome task,” he said. “I get that you’ll move the machines to one precinct, if you consolidate. I still think there could be bottlenecks at check-in. It would appear that we are doing things to make it more difficult for the voter.”

The bill ultimately passed on a vote of 27 to 7. All three Democratic senators were joined by Republican senators Jason Barrett of Berkeley, Laura Chapman of Ohio, Patrick Martin of Lewis and Ben Queen of Harrison in voting against the bill.

The Senate also passed Senate Bill 631, which would facilitate the state’s use of federal money from the Help America Vote Act in federal elections. Also known as HAVA, Trump said the bill was passed by Congress after the 2000 presidential election to help facilitate vote counting in states.

“As the technology of voting machines has become more advanced, they become more expensive. And so in West Virginia, the voting machines that are used by the 55 counties are purchased with combinations of county monies and federal monies,” he said. “This will allow the secretary of state to utilize federal monies that come into the secretary of state’s possession for that purpose.”

Senate Bill 631 also extends the deadline for when county clerks can accept voter registrations on the final day of registration by a few hours, from close of business to midnight.

Senate Bill 644, which aims to clarify the procedure for contested elections, also passed.

“In short, what this bill does is it moves to the courts the place where election contests occur,” Trump said. “If there’s an election contest from a municipal election, the current law is that it’s decided first by the mayor and council. Contests of elections involving the county and district contests, current law is that they’re decided in the county court. This moves all that to circuit court.”

All three bills now go to the House of Delegates for consideration.

Support For Diabetics

The Senate also took up two bills to address issues around diabetes in the state.

Senate Bill 195 would allow a licensed healthcare provider to prescribe ready to use glucagon rescue therapy in a school, or in a school district’s name, to treat severe hypoglycemic episodes.

The bill also sets forth procedures for administering glucagon, including the requirement that a school nurse approve its administration, and authorizes school personnel to receive training on assisting students in diabetes care and how to identify and react to a student experiencing a diabetes related emergency.

Senate Bill 577 would limit the cost sharing for a covered prescription of insulin to a total of $35 for a 30-day supply, and $100 for a 30-day supply for covered diabetic devices.

Senate Health and Human Resources Chair Sen. Mike Maroney, R-Marshall, said the bill would apply to West Virginians that currently have private health insurance.

“Our bill applies to private insurance, the 20 percent of West Virginians that have commercial insurance, roughly. That’s what this bill applies to,” Maroney said. “Medicare already has it. PEIA has similar ranges. I can’t answer Medicaid.”

The Inflation Reduction Act capped the cost of insulin at $35 per month for Medicare beneficiaries starting in 2023.

Maroney said a similar bill passed the Senate last year but failed to complete legislative action.

Both bills passed and now head to the House of Delegates for consideration.

Diabetes, Abortion And All Things Health This Legislative Session

A number of health-focused bills came before the West Virginia Legislature this session, but only a few passed.

Diabetes: Diabetes is the most costly chronic illness someone can have, according to the Centers for Disease Control and Prevention. With potentially hundreds of dollars in out of pocket costs each month, one out of four diabetics say they have rationed insulin to pay for other necessities. West Virginians are more likely to die of diabetes complications than those living in any other state.

Del. Matthew Rohrbach, R-Cabell, is a doctor in Huntington and sponsor of House Bill 4252. He said cutting costs for diabetics could save lives. This bill would have capped copays for insulin at $35 a month (West Virginia capped these costs at $100 a month in 2020). Ultimately, it gained bipartisan support in both chambers but couldn’t be finalized by the midnight deadline on the last day of session.

It also would have cut costs for devices diabetics use to better monitor and regulate their blood sugar levels. This bill would have affected those with private insurance and the state-run insurance program PEIA. It would not have curbed costs for those on Medicaid or Medicare or who don’t have insurance.

Abortion: The Republican-controlled legislature has chipped away at reproductive rights over the years. This year, each chamber put forward their own restrictions on abortion. Senate Bill 468 passed. It will prevent women from ending a pregnancy if they believe the fetus would develop a disability. West Virginians for Life lobbied for this bill, saying it would protect the lives of those with Down syndrome. OBGYNs said this law will compromise open dialogue between physicians and patients. It awaits the governor’s signature.

House Bill 4004 would have banned abortions after 15 weeks of pregnancy (the current threshold is 20 weeks), but it didn’t pass. This bill mirrors a Mississippi law that the U.S. Supreme Court will rule on this summer.

COVID-19: The U.S. may be at a turning point in the pandemic. Cases have plummeted following the omicron variant surge, and federal health officials have relaxed masking guidelines. West Virginia lawmakers were eager to propose measures they say would get things back to normal and protect personal liberties. Several bills were introduced that would have barred entities from implementing vaccine, quarantine and masking provisions. Almost none of these bills will become law.

One bill that prevailed will bar public universities and colleges from requiring a COVID-19 vaccine for enrollment. It awaits the governor’s signature. No public institutions currently have that requirement. Another bill introduced by Del. Jordan Maynor, R-Raleigh, would have banned local and state school officials from making mask rules. It passed the House but never saw the Senate floor.

Value-based payments: Lawmakers are experimenting with different ways to fund health care in West Virginia. Patients and insurance companies are used to paying for services, a check up here, some testing there. But another, less conventional option is payment based on health outcomes.

Lawmakers approved a pilot program to pay addiction treatment centers based on what clients are doing months and even years after initial treatment. Health providers would be paid more if their clients end up with jobs, attain their own housing and don’t relapse. Lawmakers say this arrangement dangles a carrot in front of health providers so they do better.

Value-based payments won’t be widespread anytime soon, but lawmakers have adopted language that could make these payments possible in the near future for local health departments and behavioral health clinics.

These three bills await the governor’s signature.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Foster Care, Diabetes Bills Stall In W.Va. Senate

Bills with big bipartisan support in West Virginia’s House of Delegates are stalled in the upper chamber.

Senate Democrats held a press conference Wednesday to say two critical bills are on the chopping block. House Bill 4252 would cut costs for people with diabetes and House Bill 4344 would raise wages for child welfare workers. Both had overwhelming support in the House, but are now stalled in the Senate Finance Committee.

“We’re down to crunch time, it’s Wednesday. If we can’t get something going here real soon we’re going to lose these two important bills that are important to West Virginians,” said Sen. Ron Stollings, D-Boone.

According to fiscal notes, the child welfare bill would cost about $10 million a year. The diabetes bill would cost PEIA, the state-run insurance program for public workers, under $200,000 a year.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Diabetes Is Deadly, Costly For West Virginians. Lawmakers Hope To Change That.

West Virginia has the highest rate of deaths caused by diabetes, but proposed state legislation hopes to curb that.

Mindy Salango is a mom living in Morgantown and an advocate with the national group Protect Our Care. She said diabetes dictates everything she does in a day.

“It just really kind of ate at me the other day that my body is never going to function properly, and that I always have to fight and stay on top of it to stay alive,” Salango said.

To keep her blood sugar in check, Salango wears a device that checks her levels every ten minutes. She counts her carbs and injects insulin seven or eight times a day. She does this to prevent suddenly fainting at her steering wheel or having her daughter have to call the ambulance.

“She has had to watch me pass out from low blood sugar more times than I care to have had her see that. And she’s had to, call emergency services to get them to help me because she couldn’t wake me up,” Salango said.

Diabetes is the most expensive chronic health condition, according to the Centers for Disease Control and Prevention. However, not all insurance plans are equal, and the financial costs of the disease can be too much to bear. Salango remembers having to ration her insulin, a risky thing to do.

“I would have to not take as much, not eat as much, not eat as often, so that I could pay the bills, have food on the table for my daughter, keep our mortgage paid,” Salango said.

This is common; one in four diabetics say they have rationed their insulin in the past two years, according to the American Diabetes Association.

June Diabetes Pkg From TLT 02-11-22.mp4

“People with diagnosed diabetes have medical costs that are nearly two and a half times that of people who don’t have diabetes,” said Gary Dougherty, the association’s director of state government affairs

The ADA says a diabetic spends on average $9,000 a year treating their disease. The cost of insulin is three times higher than it was 20 years ago. Dougherty says a single vial of insulin can cost around $300.

“You can quickly see how the more vials of insulin somebody uses, how that cost can climb very quickly and sometimes into thousands of dollars,” Dougherty said.

About 16 percent of West Virginia adults have diabetes and are subject to these costs. State lawmakers have taken notice and acted. In 2020, the state legislature created a law that capped the amount a person could pay for insulin at $100 a month.

Del. Barabara Evans Fleischauer, D- Monongalia, brought forward that first step. She looked at other states’ laws and even traveled to Canada in 2019 with a group of diabetics to purchase much cheaper medications.

“We decided to go to Canada, to demonstrate that it didn’t have to be the way it is in the United States,” Fleischauer said. “Some of the people saved hundreds of dollars that day. And that was sort of to let people know that we could do things differently in West Virginia.”

But Fleischauer says there’s more to do. This year’s House Bill 4252 passed overwhelmingly in the lower chamber. The bill now sits in the Senate’s health committee. It would drop the price of insulin from $100 a month to $35 dollars a month. It would also reduce the cost of devices diabetics use.

“[The bill] says that you can have an insulin pump every two years for $250. Those pumps, if you had to buy one off the market, are $5,000 to $7,000. And they literally will extend your life by a decade or two,” Fleischauer said.

Access to an insulin pump and other technology makes it easier for diabetics to control their illness, and that keeps people healthier and living longer. A West Virginian is more likely to die of diabetes than someone living in any other state, at about 1000 deaths a year.

A Cabell County doctor and the bill’s sponsor, Del. Matthew Rohrbach, R-Cabell, has seen patients wind up in some of the worst circumstances.

“Heart attacks, strokes, peripheral vascular disease, amputations, the need for prosthetics because of the amputations, those are all lessened if people will keep their diabetes under control. So this bill is an attempt to at least financially help them do that,” Rohrbach said.

If this bill passes, insurance companies will take on the extra costs, but Rohrbach says preventative care is essential to avoiding catastrophic outcomes, both physically and financially.

“I think the insurers can see the value in helping people be compliant. And in the long run, does it cost them a little bit more each month? Yes, but does it save a whole lot more each month? Yes. So it really is back to the ‘you can pay me now, or pay me later’ situation,” Rohrbach said.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.