Assembly Committee Clears Karabinchak, Armato & Quijano Bill Requiring Insurers to Cover Insulin, Cap Monthly Out-of-Pocket Cost at $50

(TRENTON) – To preserve affordability and accessibility of prescription insulin for diabetes patients as prices have skyrocketed, the Assembly Financial Institutions and Insurance Committee moved to advance legislation Thursday that would require New Jersey’s health benefits plans to include coverage for insulin and limit copayments or coinsurance for monthly prescriptions to $50.

The bill (A-954) is sponsored by Assembly Democrats Rob Karabinchak, John Armato and Annette Quijano.

A recent study found that the price of insulin between 2002 and 2013 tripled. Rising from $4.34 per milliliter to $12.92 over this 11-year period, the dramatic price hike has left both type 1 and some type 2 diabetics in the United States – who rely on insulin to control their blood sugar levels – unable to afford their prescription.

“Diabetics need insulin like the rest of us need oxygen,” said Karabinchak (D-Middlesex). “It’s not an optional medication, yet people are treating it that way because the cost for many people is totally prohibitive. I find that simply outrageous, no one should be spending $6,000 a year or more on a medication they need in order to live.”

Under provisions of the bill, all state insurers providing benefit plans under the New Jersey Individual Health Coverage and Small Employer Health Benefits Programs, the State Health Benefits Program, and the School Employees’ Health Benefits Program would be required to cover insulin and cap prescription costs.

“Rationing, or even foregoing, a prescribed dose of insulin has become the compromise many diabetics are making often and it could cost them their life,” said Armato (D-Atlantic). “That is unacceptable and wrong. With this bill, we would effectively reduce the cost of insulin by nearly 90 percent so no one has to face that kind of choice.”

The legislation would further require annual reporting by insulin manufacturers on the manufacture, pricing, and sale of insulin products to the Commissioner of Banking and Insurance.

“While this bill is a step in the right direction to protect consumers and save lives, we also need to assess what is happening across the entire supply-chain,” said Quijano (D-Union). “Only by identifying the root cause of these massive price hikes can we work toward an equitable, sustainable future for both consumers and insurers.”

The bill now goes to the Speaker for further review.