A bill introduced to the Kentucky House of Representatives floor on Monday by the Greenup County representative is set to cap insulin costs, while another is projected to slightly raise health care premiums.
The bills are just two of many bills Dr. Danny Bentley, R-Russell (98th District), filed to the floor on the session’s opening day.
Last year, before COVID-19 restrictions hit in mid-March, Bentley’s insulin bill passed the House 92-0, but was subsequently snuffed out in the Senate. That bill, HB 12, would have capped insulin co-pays at $100 per month for the patient.
This year, Bentley has reintroduced a similar measure, garnering 22 co-sponsors, two of which are Democrats.
Unlike last year’s bill, this one would drastically cap the cost of insulin to a $30 copay for the patient. In addition to capping that cost, the bill prevents insurers requiring less than $30 copay from raising its requirement to the limit.
The bill excludes government employee health care plans.
So far, the bill has went to the floor and had not been moved to committee.
One of the co-sponsors of Bentley’s bill, Rep. Patti Minter, a Democrat of Bowling Green’s 20th District, has also introduced a similar measure. While similar to Bentley’s bill, Minter’s HB 123 would cap costs for 30-day supply at $25 for insulin and $45 for a 30-day supply for other diabetic medication, such as Metformin. In addition, Minter’s bill does not appear to exclude state employees.
So far, Minter has not received any co-sponsors.
Minter, along with Rep. Attica Scott, D-Louisville (41st District), have also submitted a bill for an emergency insulin program that would help low-income people needing insulin who are ineligible for Medicaid.
At what cost?
Bentley submitted HB 114 Monday to the House floor that would mandate that health care plans take coupons and vouchers on prescription medications into consideration when calculating the out-of-pocket cost the patient has to cover.
The bill would only apply to name-brand drugs if a doctor determines it is medically necessary or the insurance company has given its blessing. Otherwise, the patient would have to go with a generic alternative if available for treatment, per the bill.
According to the Kentucky Department of Insurance, this would amount to a 0.2% in premiums for Kentuckians, excluding Medicaid recipients and state employee health care plans.
Bottom line, according to the department, is it would raise premiums by around $13 a year for enrollees, without increasing administrative expenses of insurers.
In its anaylsis of Bentley’s bill, the Department of Insurance cited three studies, all of which show the use of coupons for prescription drugs winds up raising the price of a branded drug. According to the studies, in cases where a branded drug had a coupon, the drug cost rose around 12% year over year. However, in cases where a branded drug does not have a coupon, it rises only 8%.
All studies noted the use of coupons have had little effect on generic drugs.
While the patient can save at the pharmacy counter with the coupon, the studies said the insurance company is still forced to pay a higher share than if a generic drug is used. While Bentley’s bill has language steering patients towards generics — only allowing the coupon to be put towards the deductible name brands if medically necessarily or insurance approved — that cost still gets made up in the premium, per what the studies show.
As of Friday, the bill has not moved to any committees. So far, only Rep. Steve Sheldon, R-Bowling Green (17th District), has signed onto the bill. Sheldon, a pharmacist, sits on the Health and Family Services committee with Bentley.
Those aren’t all the bills Bentley has introduced. Here’s a few more that were put to the floor Monday:
• HB 94: This new section to the state code would require doctors prescribing opioids to also prescribe an overdose reversal drug, such as Narcan, alongside it. So far, no state reps have signed onto the measure.
• HB 219: This bill would simultaneously eliminate the record keeping of syringes, while also limiting the sale of the item. HB 219, which has only been co-sponsored by Sheldon so far, limits the sale of hypodermic needles without a prescription to 30 per person. Syringes can be sold without a prescription to folks 16 or older with proper ID. With each sale of the rigs will come information about safe disposal, referral information about substance abuse treatment and an offer for naxolone, an overdose reverse medication. Previously, pharmacists had to maintain records on the purchaser as well as details about the transaction.
• HB 49: This eliminates sales tax on incontinence — bladder issue — products such as adult diapers for those who have been diagnosed with the issue and are prescribed the product. Kentucky already has existing legislation eliminating tax on prescription drugs, insulin supplies, prosthetics, oxygen cylinders and other medical equipment.
• HB 48 and HB 222: These bills relate to the administrative end of health care, specifically for pharmacists and Medicaid. HB 48 addresses reimbursement for pharmacists by insurance providers, while HB 222 would require the state Medicaid program to contract out monitoring of pharmaceutical claims. So far, only Sheldon has signed to HB 48.
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