Texas legislature passes insulin copay cap

Local News

Editor’s note: This story has been corrected to reflect that people with type one diabetes need more varied types of insulin than those with type two. In our interview with Dr. Castillo, he inadvertently said type 2 diabetics required more varied types.

HARLINGEN, Texas (KVEO) — On May 24, the Texas State House of Representatives voted to pass a Texas State Senate bill that could cap the out-of-pocket cost of insulin.

The bill, Senate Bill 827 (SB 827), caps the copay for insured people with diabetes at $25 for a 30 day supply.

“Prices of insulin have been skyrocketing, literally, to the point where it’s unaffordable,” said Dr. James Castillo, the Cameron County health authority.

A study from the American Diabetes Association shows that “the average list price of insulin has skyrocketed in recent years, nearly tripling between 2002 and 2013”.

Castillo said that those soaring prices have caused some patients to make some tough choices regarding their health.

“Some patients will even not take as much insulin as their doctors ordered to try in order to make that supply last longer to try and save money, but in the long run that’s bad for their health,” Castillo said.

Segment of SB 827.

SB 827’s copay cap applies to all forms and types of insulin.

This is good for diabetics who have insurance that doesn’t fully cover their insulin, but the fact that the bill’s language specifies any type or amount greatly benefits people with type one diabetes, who require more varied types of insulin than those with type two.

“[Type one diabetic] patients typically need two different types of insulin, one that’s long-acting and the other one that they take depending on how much they’re eating to try and keep their blood sugar levels in a normal range,” said Castillo.

One complaint about SB 827 is that it only lowers the price of insulin for people with insurance, not those on Medicaid or people who are uninsured.

“It definitely helps protect the patients, but it seems to do little to influence the price of insulin,” said Castillo.

Over a quarter of people in the Rio Grande Valley have diabetes. According to the Texas Comptroller, the Rio Grande Valley has an uninsured rate of over 25% as well.

For people who fall into both groups that are concerned about affording insulin, Castillo said there are ways to get help.

“If a person doesn’t have health insurance, and they need insulin, go look at insulinhelp.org,” said Castillo.

Texas House of Representative member James Talarico said the passage of this bill was a stepping stone to making insulin-free for everyone.

Governor Gregg Abbott will have 20 days to either sign or veto the bill. If he does nothing, it will become law automatically at the end of 20 days.

If signed into law, the bill will take effect on September 1.

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