Emily Allen Published

W.Va. Senate Passes Bill To Cap Insulin Copays At $100 Monthly


A bill to cap insulin copays passed the West Virginia Senate Friday afternoon. 

House Bill 4543 would cap the copay on insulin, medication to help the body process sugar, at $100 per month. 

In February, the House of Delegates passed a bill that set the copay cap at $25. An amendment from the Senate Health and Human Resources Committee Tuesday increased the cap. The bill passed in the Senate 33 to 1.  

“We’ve got people dying all over the country because they can’t get access to insulin,” Nancy Tyler, a Type 1 diabetic, said after the Senate Health meeting. “And we have people that can’t afford to burden their families, for example. So they take half the insulin they’re supposed to take. And they’re going to end up with kidney failure, potentially, heart attacks, strokes,” 

Tyler is vice president for the West Virginians for Affordable Health Care group, and she’s former counsel for the House Health Committee. She testified to senators Tuesday afternoon before they passed the amended version of the bill. 

“It would be preferred to stay at $25, because for some people $100 isn’t going to be that different a cost,” Tyler said in an interview afterward. “But, you know, … at least $100 is not $800 or a $1,000, which is what people are having to pay.” 

As House Bill 4543 snaked its way through several committees this year, lawmakers reluctantly shared some concerns regarding who will bear the brunt of the cost difference if consumers aren’t paying it. 

“If we cap the cost of the drug, I just want to know, who pays the difference?” Sen. Patricia Rucker, R-Jefferson, in the Health Committee on Tuesday. 

An amendment from Senate Health prohibits pharmacy benefit managers, which negotiate between the drug manufacturers and pharmacies, from reimbursing a pharmacy for drugs at a lower rate than was purchased. 

Otherwise, various committee counsel has said the bill, in all of its version, puts most of the cost on pharmacy benefit managers, drug manufacturers and distributors. 

West Virginia is not the first state to establish a cap, nor is it the only one to do so this year. In Colorado, the state Legislature agreed in 2019 to set a $100 cap for insured consumers

Illinois Gov. J.B. Pritzker signed a similar bill into law in January. 

Virginia’s Legislature agreed to a $50 cap on Friday.

Sen. Mike Romano, D-Harrison, said Friday the bill has his full support. 

“That’s not the bill we had here 10 days ago,” Romano said, regarding the change from the $25 cap. Still, he referred to the bill as a “really good compromise.” 

The bill now goes to the House of Delegates where lawmakers there have the option to concur with the right to amend, or to accept the Senate’s cap.

Emily Allen is a Report for America corps member.