Proposed insulin price cap for North Dakota public employees gains traction

In response to high insulin prices, nearly two dozen states have set price caps on the drug in just the last three years.

North Dakota Sen. Tim Mathern, D-Fargo, speaks at a legislative hearing on Jan. 10, 2023.
Jeremy Turley / Forum News Service

BISMARCK — A high-profile bill to limit the price of insulin for public employees has survived its first major test.

The North Dakota Senate voted 34-12 on Wednesday, Feb. 8, to approve Senate Bill 2140, but the legislation will face another vote in the chamber after budget writers consider its fiscal impact.

The original version of the bill brought by Sen. Tim Mathern, D-Fargo, would have capped the price of a 30-day supply of insulin at $25 for all North Dakotans on employer-sponsored fully funded insurance plans. Co-payments for related medical supplies, including blood glucose meters, insulin pen needles and syringes, also would have been capped at $25 per 30 days.

The Senate Human Services Committee amended the bipartisan bill so the $25 caps only apply to residents who are covered by the North Dakota Public Employees Retirement System, or PERS. State law requires legislators to run insurance mandates through a PERS trial before expanding the policies statewide.

About 60,000 current and retired public employees and their dependents are covered by PERS.


The Senate narrowly defeated a similar proposal in 2021, but Wednesday’s vote signals a greater appetite for the bill this year.

The average manufacturer price of insulin in the U.S. was about 10 times higher than in other developed countries as of 2018, according to a 2020 report prepared by nonprofit think tank RAND Corporation.

In response to the high prices, nearly two dozen states have established insulin price caps in just the last three years.

Sen. Dick Dever, R-Bismarck, said Wednesday that pharmaceutical companies can make the century-old drug cheaply and shouldn’t be demanding such hefty payments from diabetic Americans.

“There is no reason for Big Pharma to be charging the kinds of dollars that they do for insulin,” Dever said.

Kristin Roers.jpg
North Dakota Sen. Kristin Roers, R-Fargo.
Contributed photo

Sen. Kristin Roers, R-Fargo, opposed the bill, noting that insurance mandates generally drive up premiums for everyone covered by an insurance plan. She said private insurance companies recently have begun self-imposing insulin price caps for some plans they provide.

Roers added that a state-enforced insulin price cap wouldn’t apply to North Dakotans covered by self-funded insurance plans, Medicare or Medicaid even if it were rolled out statewide in the future. That means only about 20% of insured residents could benefit from a price cap, she said.

Sen. Sean Cleary, R-Bismarck, argued that “just because this impacts a small amount of people is not a reason to discard it.” He called the bill “an incremental step” in improving drug affordability for North Dakotans.


“While the free market is the reason why our country is one of the greatest, most prosperous, most innovative countries on earth, for those folks who are paying hundreds of dollars a month (for insulin), the free market is not working,” Cleary said.

A well-attended hearing on the proposal at the state Capitol last month pitted mothers of diabetic children against lobbyists for insurance providers.

Bill proponents said life-saving drugs shouldn’t be cost prohibitive, while insurance lobbyists argued the price cap would drive up medication prices and prevent pharmaceutical innovation.

Jeremy Turley is a Bismarck-based reporter for Forum News Service, which provides news coverage to publications owned by Forum Communications Company.
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