Login | April 17, 2026
Legislation would limit cost-sharing requirements for insulin drugs
KEITH ARNOLD
Special to the Legal News
Published: June 13, 2024
Lawmakers recently heard testimony from the sponsors of a bill that proposes capping health insurance providers’ cost-sharing requirements on prescriptions for insulin drugs and diabetes care devices.
Rep. Munira Abdullahi, a Columbus Democrat, told members of the Insurance Committee in the Ohio House of Representatives that Ohioans with diabetes are not getting their money’s worth relative to what they pay for insulin and the related diabetes-care devices such as testing strips, lancets and continuous glucose monitors.
“When measuring Ohio’s performance on population health outcomes and health-care spending, Ohio ranks 40th out of 50 states on adult diabetes,” she said.
Abdullahi said the cost of insulin in the United States is nearly 10 times the world average, according to the international scale.
“The average price in America is $99, while it ranges from $21 to as little as $8 in countries like Mexico, Canada and South Korea––a fraction of what Americans are paying for this vital medication,” she said. “The staggering cost of insulin is burdensome to all those who depend on this life-saving medication.”
House Bill 384, upon its enactment, would limit cost-sharing requirements in excess of $35 in aggregate for a 30-day supply of all covered prescription insulin drugs prescribed for the covered person, analysis by the Ohio Legislative Service Commission provided.
Additionally, the bill would prohibit cost-sharing requirements exceeding $100 in aggregate for a month’s supply of all covered diabetes-care devices used by the covered person.
Those devices include blood glucose test strips, glucometers, continuous glucose monitors, lancets, lancing devices, insulin syringes and insulin pumps, according to the bill.
The analysis noted that a health-plan issuer may further reduce a cost-sharing requirement to an amount less than the $35 or $100 limits.
“For those unfamiliar, insulin is an essential hormone vital to our wellbeing and safety,” the lawmaker said. “Most bodies produce it naturally and those with diabetes or other health issues have trouble producing enough or any at all.”
Abdullahi included herself in the nearly 1 million Ohio adults diagnosed with diabetes.
“My real-world experiences as a diabetic Ohioan informs my passion for this issue and the greater issue of equitable health care,” she said.
Butler County Rep. Thomas Hall of Madison Township, the Republican sponsor of HB 384, said the state Department of Health reported that more than 12.4 percent of Ohio adults have been diagnosed with the disease.
“Further, according to the American Diabetes Association, the total cost of insulin and other medications that manage blood glucose levels increased by 26 percent from 2017 to 2022,” he said. “This critical legislation will ultimately expand access to lifesaving medication, ensuring the safety and wellbeing of diabetic Ohioans. Our goal is to put Ohioans first; to make sure that no Ohioan must choose between vital medication or other necessities, such as rent or groceries.”
OLSC analysis listed the following limitations to the cost-sharing caps:
• Only to health-plan issuers that provide coverage for prescription insulin drugs or diabetes care devices;
• Regardless of the amount or type of insulin needed to fill a covered person’s prescription; and
• Regardless of any deductible, copayment, coinsurance or any other cost-sharing requirement that would otherwise apply to the covered person under the health benefit plan.
HB 384 also would make the prescribed limits exempt from an existing law that could prevent them from being applied until a review by the state insurance superintendent.
Abdullahi said the measure would expand federal legislation that limits the cost of insulin to $35 for nearly 4 million seniors with diabetes on Medicare.
Twenty-seven House members co-sponsor the measure, which awaits further consideration by the committee.
Copyright © 2024 The Daily Reporter - All Rights Reserved