ROCHESTER — Another insurer has announced plans to protect customers with diabetes from out-of-pocket insulin charges.
Blue Cross and Blue Shield of Minnesota on Thursday, Aug. 22, announced it will cover all costs of insulin for certain customers, beginning January 1, 2020. Blue Cross becomes the third Minnesota insurer to cap out-of-pocket insulin costs. Previously, both Medica and UCare announced plans to offer policy holders a $25 cap on monthly out-of-pocket insulin charges.
The Blue Cross benefit will apply to all holders of so-called "fully insured" individual and family plans, both on and off MNsure, as well as those offered by small and large employers. Blue Cross plans set by large employers, which are generally plans offered by national corporations, have the ability to request the insulin benefit, but are not immediately affected by the change. Blue Cross did not adjust its filed premium rates for 2020 as a result of this benefit.
“Our first responsibility is to do what we can to improve the health and financial stability of our members,” said Dr. Craig Samitt, president and CEO of Blue Cross and Blue Shield of Minnesota in a statement. “We felt a responsibility to address the skyrocketing cost of insulin with the options we have available. Hopefully our action will provide some measure of financial relief to many of our members who live with diabetes.”
It's emblematic of the galvanizing place of rising insulin costs in the public eye that the insurer, like its predecessors at competitor firms Medica and UCare, announced the new coverage with a press release, a vehicle usually reserved for news of leadership changes, policy reports and corporate partnerships. Insulin is necessary for survival to rising numbers of patients with diabetes within the U.S. It is not a novel drug, has long been cheap and readily available, and yet has seen a doubling and tripling of costs for seemingly no reason other than the arbitrary testing of a new price point.
The sudden rise this year in costs for the drug, a development accompanied by patient stories of rationing, death in some cases, and the resulting attention of officeholders and candidates for higher office have vastly increased the visibility of a coverage benefit that might otherwise have gone unnoticed. It has also provided a rare, one-step policy opening for an industry dealing in abstract financial mechanisms like co-pays, co-insurance and annual deductible clauses, one often depicted as an obstacle to accessible and effective healthcare. In his statement, Blue Cross' Samit utilized the moment to draw larger arguments about healthcare inequities.
“The problem is much larger than insulin,” said Samitt in the statement. “More must be done to hold pharmaceutical companies accountable for the astronomical and arbitrary prices they set for medications that treat a range of serious and chronic issues. With no oversight or accountability, these companies will continue to charge whatever they want, with impunity. As a state, we need to work together and address the root causes of what is making affordable treatment out of reach for too many people.”
In a health care marketplace where pricing calculations are opaque and widely-felt, the seemingly uncontrollable price of insulin has become a development with high value for symbolism as well as patient care, one that seems destined to be utilized for election purposes. Following news of the Blue Cross change, Minnesota Senate Republicans issued a statement highlighting the Senate's 2019 reinsurance legislation to take credit for the news. It's been previously reported that an IRS rule change enabled insurers to offer the benefit without tax implications to customers.