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Emergency insulin proposal doesn't survive special session, will be priority in 2020

Travis Paulson holds up two seemingly identical bottles of insulin made by the same company. NovoRapid (left) is sold in Canada for $40. NovoLog (right) is sold in the U.S. for $350. Tyler Schank / Forum News Service

ST. PAUL — A proposal to require insulin manufacturers to fund a program that offers emergency access to uninsured diabetics or those who can't afford their medication will have to wait until 2020, lawmakers decided in the early hours of Saturday, May 25.

In a special legislative session, the Minnesota Senate and then the House of Representatives voted down proposals that would offer stopgap insulin supplies for Minnesotans who couldn't get them otherwise.

The proposals came up as lawmakers weighed the biggest, most complex budget bill that funds health and human service programs, mostly for poor and disabled Minnesotans. The legislation takes up about 40% of the state’s $48 billion, two-year budget.

Sen. Melissa Wiklund, D-Bloomington, narrowly failed in her attempt to get senators to adopt an amendment to help diabetics who cannot afford insulin. Her proposal called for charging insulin makers a fee.

Sen. Jim Abeler, R-Anoka, said senators have not had enough of a chance to study the provision. Other provisions to help diabetic get emergency insulin supplies and other drugs are in the overall bill.

The amendment failed when 33 senators voted for the amendment and 34 voted against it. That narrow split fueled a push in the opposite chamber to bring a similar amendment.

At around 3:45 a.m., the House had a chance to cast a vote on an amendment that would provide for the emergency insulin funded by the state's Health Care Access Fund. Rep. Rod Hamilton, R-Mountain Lake, said the House should approve the plan as part of the larger spending bill and push the idea to the Senate for their confirmation.

"This is the right thing to do," Hamilton said, pointing to the advocacy of Nicole Smith-Holt, whose son Alec Smith died of complications of Type 1 diabetes after he rationed insulin.

Smith-Holt spent months making her case to lawmakers that they need to hold insulin manufacturers accountable for their mushrooming prices and make life-saving drugs available.

That's what the Senate amendment proposed, Rep. Mike Howard, D-Richfield, said, but the House plan wouldn't have quite the same effect. Howard for the five months of the legislative session displayed a photo of Alec Smith on his desk and pushed for the emergency insulin proposal to pass.

"Absolutely no one should lose their life because they can't afford the insulin they need to survive," Howard said. "These companies can make billions of dollars and they absolutely should be held accountable for the harm that they've caused."

The House voted down the measure Saturday morning, sinking the proposal's chances this year.

Both Senate and House majority leaders said the proposal would be a bipartisan priority in the 2020 legislative session.

Final piece of budget puzzle comes to light

The health and human services bill came to light hours before lawmakers were expected to vote on it. And while some had concerns about pieces of the plan, it gained widespread support in both the House and Senate.

“The breadth of this bill and how it touches so many lives, it is just nice to talk about,” said Abeler, chairman of a committee dealing with the issue.

“If you are poor, there is something here for you,” added Sen. Michelle Benson, R-Ham Lake, chairwoman of the other Senate committee tackling such issues. “We are protecting nursing homes, the needs of the disabled.”

The 650-page bill falls between the size of the original 1,000-page House legislation and the Senate plan.

“I don’t know if there was another bill where the House and Senate were further apart than on this bill,” Human Services Commissioner Tony Lourey said. “The core of the compromise was resizing the provider tax and being able to invest in some of the things that mean a lot to all of us.”

Like most bills, much of the House and Senate discussion centered on what did not get done.

Health Commissioner Jan Malcolm said one of her disappointments was the failure to invest enough in helping prevent health problems, such as smoking, the No. 1 cause of premature death. She also complained that not enough was being done to prevent suicides.

On the other hand, Malcolm joined many legislators who support an effort to find $100 million in savings in her department and the Human Services Department.

The health and human services bill extends funding for what is known as reinsurance, which provides health insurers money to allow them to pay high claims, an effort to keep premiums affordable.

The legislation boosts spending on children with major or medium disabilities and helps some assisted living centers now struggling financially, Abeler said. The measure also steps up the fight against fraud in the Minnesota Child Care Assistance Program and adds vaping to the existing smoking ban in workplaces, bars and restaurants.

Bonding proposal 'resting its eyes' in final hours of session

A state construction project funding bill is ready and waiting — for Feb. 11, when legislators return to St. Paul.

Rep. Mary Murphy, D-Hermantown, said her committee charged with crafting a construction bill funded by the state selling bonds has a nearly $500 million plan funding 165 projects. But senators on a similar committee never met, and there were few conversations between the two bodies on the issue in recent days.

So the special legislative session that ended Saturday morning did not take up bonding.

Bills introduced during the regular session this year, like the bonding legislation, remain alive when the next regular session starts next February. Murphy proposed considering the measure early next session, adding that it will likely be expanded.

Generally, big bonding bills come in even-numbered years, which are election years and lawmakers can tell voters about projects to be constructed in their districts. Projects often center on state college and university campuses but include everything from state government buildings to parks.

Murphy said 75% of her bill is urgent asset preservation work and emergency needs.

She complained early Saturday, with four hours available for passing bills, that the Senate bonding committee chaired by Sen. Dave Senjem, R-Rochester, did not meet this year. Senjem earlier said he did not expect a bonding bill and that he had few conversations with Murphy on the matter.

Murphy said the bill is not dead. “It is resting its eyes.”

The lawmaker, in office since 1977, said: “One thing I have learned around here is patience pays off.”

Here's a look at other spending proposals in the budget:

  • Public schools are expected to receive a per-student funding boost of 2% compared to current levels in the first year and another 2 % in the second year. The state will help offset the growing cost of special education and pay to fund 4,000 voluntary pre-kindergarten slots that were set to expire.
  • The state's second income tax bracket would be lowered to 6.8% under the proposal, which would provide tax relief to middle-class Minnesotans. The tax plan would also increase funding for city and county aid programs.
  • In the transportation spending plan, lawmakers allocated $275 million for road construction and maintenance, increased funding for Metro Mobility to expand services to Lakeville, replace the MNLARS software with a new program and pay $13 million to deputy registrars affected by the flawed MNLARS rollout.
  • The agriculture finance bill would boost funding to grow farm and rural mental health resources, provide up to $5 million in assistance and relief grants to dairy farmers and put forward one-time funds for an industrial hemp pilot program. The bill came up for a vote Monday night and passed in the Senate, but was tabled in the House.
  • The public safety spending plan would increase staffing levels for corrections officers, overhaul the state's sexual assault statutes, change the state's solitary confinement protocols in prisons and allow for the creation of a Task Force on Missing and Murdered Indigenous Women.
  • The environment and natural resources budget bill would increase funding to combat chronic wasting disease in deer, including a $1.6 million appropriation to the University of Minnesota to help scientists develop a test for the fatal prion disease. Current tests can only detect the disease after an animal dies. The bill would also require cervid farmers to set up double gates and would require that a herd be destroyed if the disease is detected.
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