WA’s insulin affordability bill, to lower many copays to $35, awaits governor’s signature

Washington is set to be the 19th state to address the insulin price crisis, as a bill that lowers some insulin copayments from $100 to $35 moves out of the Legislature and is on the governor’s desk.

Should Senate Bill 5546 be signed into law, it would cap insulin copayments at $35 for a 30-day supply of the medication for all Washingtonians on state-funded insurance plans, such as public servants and those on certain Medicaid plans. The cap does not apply to private insurance.

The measure, something diabetes advocates have long pushed for, would align the state with President Joe Biden’s insulin payment agenda, which calls for a $35 copayment cap nationwide and was mentioned during Biden’s State of the Union address Tuesday.

According to the Washington Department of Health, nearly 1 in 8 people in the state live with diabetes, and roughly 1 in 3 of those depend on insulin to regulate their blood sugar levels.

Losing access to insulin puts diabetic people in potentially life-threatening situations: Kidney failure, blindness and even death can all be caused by ketoacidosis, a dangerous metabolic state that is caused by a lack of insulin.

According to figures from the state’s Health Care Authority and Democratic Senate policy staff, roughly 3 million people — less than half the state — are enrolled in health plans that would qualify for the copay cap. Advocates say that setting insulin price caps, as opposed to payment caps, would go further toward making the medication more affordable for everyone in the state.

Many diabetes advocates and supporters of the bill say that it doesn’t do enough to address the real reasons behind the recent trend of hiked insulin prices: complicated insurance plans and pharmaceutical manufacturers benefit from inflated prices of insulin. According to a report by the Department of Health, the total cost of diagnosed diabetes in Washington was $6.7 billion in 2017.

“It really isn’t a perfect solution, if I’m being honest with you. It’s one of those Band-Aid pieces of legislation rather than a transformative solution that would really get at the root cause of why insulin is so expensive,” said Madi Johnson, leader of the Washington chapter of #insulin4all, a group raising awareness about the insulin affordability crisis. “But, you know, even if we were helping five people, it would still be worth it.”

A related bill passed both chambers on Thursday that would fund a work group tasked with creating strategies to lower the cost of insulin in Washington. The work group had been unable to meet and their funds had expired due to the pandemic.