Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.
Pressure Builds On DHHS Director Confirmation Vote
Three more Republican senators urged for the rejection of the appointment of Department of Health and Human Services Director Elizabeth Hertel March 4, while Democratic legislators are beginning to rally around her confirmation.
Sens. Tom Barrett (R-Potterville), Jim Runestad (R-White Lake) and Dale Zorn (R-Ida) joined three other colleagues in urging for a vote to reject Hertel based on her support, in part, on “her absurd and blatantly unconstitutional belief” that DHHS directors can, theoretically, issue public health orders that restrict public movement “forever.”
“The Senate should decline to consent to Director Hertel’s appointment and advise Gov. (Gretchen) Whitmer to appoint a director who will uphold the separation of powers and collaborate with the Legislature to address public health issues,” the letter reads.
Meanwhile, Senate Minority Leader Jim Ananich (D-Flint) stood up for Hertel as someone “qualified, capable and dedicated” to the state.
“Her resume is a mile long and she’s proven to be extremely successful working with Republicans and Democrats, in the private and public health sectors, in both policy and administration,” Ananich said.
“Should Senate Republicans manipulate the advice and consent process to achieve a political goal, that would send a terrible message to Michigan residents, that their agenda is more important than the success of our state’s health services.”
Pressure on what Senate Advice and Consent Committee Chair Aric Nesbitt (R-Lawton) should do is building given the timeframe involved. The Constitution reads the Senate has “60 session days” during which to act.
Senate Republicans would argue those 60 days are the days the Senate is actually in session, which based on the calendar would stretch a decision June 29. However, a 1964 Attorney General Frank Kelley opinion interprets the timeframe as meaning 60 days in which the Senate is in session, including Sundays. That makes the deadline March 23.
The Legislature could challenge the ruling in court, but that would drag out the process and not have the immediate effect of taking a definitive action against the governor’s one-person-rule leadership philosophy.
The best way to tell the governor that this isn’t going to fly is to continue to reject appointments until she gets the message and changes her way.
The counterargument is Whitmer won’t change her way. If Hertel is not acceptable, it’s likely nobody will be.
Whitmer will continue to appoint DHHS directors that align with her way of thinking. The Senate will be forced into its own absurd result of rejecting everybody she sends their way. Are they OK rejecting a dozen DHHS director appointees or more until her term ends?
Also, many Republicans would concede privately that they like Hertel. She’s been helpful in the past on issues in their districts or on policy matters in her various roles in and out of state government. Whitmer definitely could do worse on an appointee and that’s the problem.
To borrow an outdated phrase, is it better to have the devil you know or the devil you don’t know?
The fact Hertel is married to another member, Sen. Curtis Hertel Jr. (D-East Lansing), likely doesn’t play a direct role in the decision, but it does add an unspoken level of discomfort about rejecting Elizabeth Hertel on a human level.
Sure, one could argue a rejection would be simply business, but the Senate, in general, is a traditionally more collegial body than the House. How awkward would it be in the future to work with someone whose wife you publicly voted out of a job?
Sources tell MIRS Republicans haven’t taken an official caucus position on Elizabeth Hertel’s future. For now, Nesbitt will hold a third hearing and the committee will go on from there.
The Senate only has 36 members elected and serving at this point. If all Senate Democrats vote no on rejection, Republicans couldn’t lose more than one member and a rejection vote would fail.
“It’s all up in the air,” one source close to the situation concedes.
Meanwhile, other groups are beginning to weigh in on the issue.
At a March 4 hearing, more than a dozen groups representing various health groups turned in cards in support of Hertel, including AARP of Michigan, the Economic Alliance for Michigan, Henry Ford Health System, Priority Health, Meridian Health, the Michigan State Medical Society, Spectrum Health, the Michigan Health and Hospital Association, Blue Cross Blue Shield of Michigan, Beaumont Health and Paramount Care, Michigan Association of Health Care, Trinity Heath and Delta Dental.
The Michigan Association of Superintendents & Administrators and the Michigan Association of School Boards issued a statement in support of Hertel’s appointment.
Those turning in letters of opposition included Janice Daniels, vice president of the Election Integrity Fund and Michigan Conservative Union, and several other Michigan residents.
Theis: Where Are Our Vaccines In Livingston?
Sen. Lana Theis (R-Brighton) questioned the latest vaccine expansion to people over 50 when “Livingston County has over 13,000 seniors who signed up for a vaccine, but have yet even to get scheduled for their first dose,” according to a press release issued by her office.
Theis said her “office has received hundreds of calls and emails from frustrated constituents who have signed up at dozens of locations and even in multiple counties. These are our most vulnerable residents.”
Based on 2020 U.S. Census estimates, Livingston County has the state’s 11th highest population with 189,754 residents. By comparison, Saginaw County has 191,821 residents and Muskegon County has 173,297.
According to the state’s own numbers, 23,150 vaccines have been distributed in Livingston as of Wednesday. Muskegon County has had more than double the vaccines distributed—47,805. Saginaw County has nearly three times the vaccines distributed—70,855.
Bay County, which has nearly half the population of Livingston at 104,104 residents, has had twice the number of vaccines as Livingston at 43,750 doses.
One possible explanation is the use of the Social Vulnerability Index in determining who receives the vaccine. Livingston County is the state’s second most wealthy county with a median household income at $72,129. The thought is that Livingston residents are wealthy enough to remain home and have supplies delivered to them, whereas residents of poorer, urban areas don’t have that same luxury.
Theis doesn’t buy it. As far as she is concerned, the vaccine should go to areas based on their population of adults 65 and older.
“Make no mistake, more people getting a COVID-19 vaccine is a good thing and will help us return to a more normal way of living sooner,” Theis said. “Unfortunately, in this effort, politics is dictating policy—itself an infection that is eroding the moral fabric of our society. Instead of a policy that prioritizes vaccine distribution based on medical needs, this administration is doubling down on a politically driven policy of social equity.”
Michigan Department of Health and Human Services spokesman Bob Wheaton said that “the timing of the start of vaccination in a phase is dependent on the supply of vaccine from the manufacturer, how vaccine is allocated from the federal level to Michigan and the capacity to administer the vaccine to populations.”
He cited the announcement from President Joe Biden that the United States can expect 300 million doses by the end of the May in moving to the next phase of eligibility.
Wheaton said that in recognition of the recent update to the federal plan to increase production of the vaccine, the state is planning to announce the next round of eligibility in the near future.
As of today, more than 3 million vaccines have been shipped in Michigan and 2.4 million have been administered. In COVID cases, another 1,526 cases were confirmed and 37 deaths were added, for totals of 593,279 cases and 15,600 deaths.
MI Teachers Not Demanding Vaccine Before Returning To Class
In other parts of the country—including Chicago, New Jersey, New Mexico, Massachusetts and Texas—there’s been a heated debate over teachers not returning to classroom instruction until and unless they receive the COVID-19 vaccine first.
Not so in Michigan, according to one school leader.
“We’ve heard that anecdotally, but not in mass,” reported the associate executive director for the Michigan Association of School Administrators (MASA) Peter Spadafore.
There’s been no effort in the state to make the shots mandatory before instructors and staff return. Gov. Gretchen Whitmer says that effort should be “prioritized” as she urges schools to reopen in-person learning this month.
The new director of the Centers for Disease Control and Prevention, Rochelle Walensky, told school districts that based on “increasing data the vaccination of teachers is not a prerequisite for the safe reopening of schools.”
The Michigan Education Association has not made any move to mandate the shots as it reports this is up to individual districts to determine their own vaccination policies.
Spadafore told MIRS, “I think the teachers are comfortable with the safety measures we’re putting in place in schools and for the most part students are adhering to that. If there are outbreaks, there is quick contact tracing so that it doesn’t spread. Districts have heard that some won’t come back so they are starting with the willing teachers.”
He also noted that in some districts 25 percent of the parents don’t want their children to have face-to-face learning while in others “you see everyone wanting it.”
Asked if he expected a revolt like the one seen in Chicago last month, he does not.
“I don’t anticipate that. The teachers themselves and the unions have been very cooperative in trying to get students back. They know how important in-person learning is and when we do hear these anecdotal stories, it’s one offs. It’s not the rule. It’s not in general.”
Bill Would Expand Scope Of Practice For Nurse Anesthetists
Certified Registered Nurse Anesthetists (CRNAs) would be allowed to work without the supervision of a physician under a scope of practice bill taken up in the House Health Policy Committee March 4.
HB 4359 would address the issue most critical for smaller hospitals in rural areas where an anesthesiologist is not always available.
“Forty-two states have no physician supervision requirement for CRNAs and 19 of those states have opted out of the federal Medicare supervision rule for nurse anesthetists,” sponsor Rep. Mary Whiteford (R-Casco Twp.) told the committee. “Michigan cannot opt out because the state’s definition of nursing practice does not include nurses giving anesthesia independently. Updating this law would allow this.”
Dr. Bobby Mukkamala, a Flint otolaryngologist and president of the Michigan State Medical Society, opposes the bill.
“By my calculation, there are about 10 hospitals out of the 150 in the state that are in the situation you are talking about, no access to an anesthesiologist that’s around them. So, you are passing a bill that changes the standard of care for the entire state of Michigan—all 150 hospitals—to address the needs of 10 hospitals,” Mukkamala said.
Someone might come to the hospital with a “hot gallbladder” that needs immediate removal, Mukkamala explained, but if that only happens once a month, does that hospital really need 24/7 anesthesia care? It might be better to transfer the patient, he suggested.
Dr. Roy Soto, a physician and anesthesiologist at Beaumont Hospital representing the Michigan Society of Anesthesiologists, said he opposes the bill when Health Policy took up the issue again today.
“I personally feel that the safest model of care involves multiple levels of supervision and oversight,” Soto said. “. . . The person with the most medical training in anesthesia is the anesthesiologist. We already have made exceptions to allow a non-anesthesiologist to supervise anesthesia delivery by a nurse anesthetist for lower risk procedures, which are typically what we see in an outpatient rural setting. To remove all supervision from CRNAs would be going another step away from the person with the most anesthesia training, and so it does not seem to make sense from a safety point of view.”
From the patient’s perspective, the cost is the same, Soto said.
Actually, costs in states that allow this have gone up slightly, according to Bret Jackson of the Economic Alliance for Michigan, and that is because of an increase in elective procedures.
“We see an increase in procedures, but the access concerns . . . are of equal concern to our members and the quality of care that is being delivered by the CRNAs is of great concern as well,” Jackson said. “What we can gather is, quality’s pretty good. And the access issues are real. So on balance, even though we think it is going to cost us slightly more, we think that care is not going to be harmed. We think the access needs to be dealt with. So on balance, we support this legislation.”
Everyone Over 50 Can Get COVID-19 Shot Starting March 22
The state March 3 announced the expansion of COVID-19 vaccine eligibility access for the first time since early January, clearing the way for everyone 50 years or older to get the shot starting March 22.
But first, beginning March 8, people 50 years or older with medical conditions or disabilities, or caregiver family members and guardians who care for kids with special health care needs will be allowed to go for the vaccines.
The Michigan Department of Health and Human Services said it’s accelerating vaccination of these individuals due to concern around disparity in life expectancy and to remove barriers to vaccine access.
The DHHS said the announced expansion follows the announcement from President Joe Biden that enough doses will be produced for 300 million Americans by the end of May. The state also cited the federal government’s recent approval of the new one-shot Johnson & Johnson vaccine for adults ages 18 and older.
“With three safe and effective vaccines now authorized for use, people should get the first vaccine available to them. These vaccines are the way we are going to end this pandemic,” said Chief Medical Executive Dr. Joneigh Khaldun, in a statement.
According to the DHHS, to date, more than 40 percent of Michiganders age 65 and older have been vaccinated, the age threshold of a previous vaccine expansion.
In early March, the state opened up more vaccine access to frontline essential workers in the food processing and agricultural industries.
The Michigan Heath and Hospital Association, the Small Business Association of Michigan and the Michigan State Medical Society all issued statements of support.
MSMS also advocated that primary care physicians be allowed to help administer the vaccines.
“Michigan’s primary care physicians must be allowed to be involved in the important work of vaccination distribution, especially now as more and more residents become eligible. I can assure you that Michigan physicians stand ready to assist in this vital effort,” said Dr. Bobby Mukkamala, president of MSMS.
Two Bills To Lower Health Costs Approved In Health Policy
Two bills aimed at keeping down health care costs—one to cap co-pays for insulin and another to allow online eye exams for those renewing contact lens prescriptions—cleared the House Health Policy Committee March 3.
HB 4346, sponsored by Rep. Sara Cambensy (D-Marquette), to cap co-pays for insulin at $50, was approved in a 13-2-3 vote.
But the bill didn’t pass until it had been amended to cap co-pays at $50 per prescription rather than $50 per month. Diabetics who use three vials of insulin in a month will end up paying $150 in co-pays.
The bill got support from Gary Dougherty, of the American Diabetes Association, who said if a vial of insulin costs between $3.69 to $6.16 to make, there’s “not a way to reconcile an equation that ends with the most commonly prescribed insulins typically costing upwards of $300 per vial and more.”
Cambensy said her insulin, the same insulin she has used for more than 30 years and used to cost $20 per vial, now costs almost $600 per vial.
Dougherty contended that while opponents argue such a bill will increase the cost of insurance premiums, similar bills passed in other states have not resulted in premium increases.
“People with diabetes are facing a crisis and they should not die because they can’t afford to live. Your constituents with diabetes should not die because they can’t afford to live,” Dougherty said.
Bret Jackson, of the Economic Alliance of Michigan, agrees that something needs to be done about the rising costs of insulin.
“We just do not agree that this is the answer to the problem. We think these bills do create a cost shift and we think they let the drug companies off the hook. They won’t be responsible for the increased drug prices if the patients are severed away from the relationship. The bills don’t impact the majority of Michiganders. These bills will impact about 2.1 million citizens, or about 24 percent of the state’s population,” Jackson said.
The bill was reported in a 13-2 vote with three passing.
Rep. Graham Filler (R-DeWitt) and Rep. Andrew Fink (R-Hillsdale) voted no. Rep. Cara Clemente (D-Lincoln Park), Rep. Lori Stone (D-Warren) and Rep. Cynthia Neeley (D-Flint) passed.
HB 4356, by Rep. Luke Meerman (R-Polkton Twp.), would allow for eye examinations and evaluations to be conducted through telemedicine. It would allow for examinations online if the standard of care were maintained at the same level as if it were performed in person.
Meerman explained the bill only allows virtual examinations for contact renewals. And only those 18 to 55 would be able to make use of online exams.
“Allowing for these examinations to be done virtually will increase the access to care for those in rural and underserved areas as well as decrease costs for contact lens renewals. It is important to know that prior to our patients being able to utilize a virtual eye exam they must undergo a comprehensive in-person eye exam,” Meerman said.
He also offered an amendment that requires a contact lens wearer to have an in-person examination every five years.
Erik Casteneda, representing 1-800 Contacts, said in testimony last week his company already requires patients to use his website. Other states already allow such services.
“Currently, there have been about a million contact lens renewals given out across the country using online platforms and at this time we are unaware of a single adverse event or medical malpractice claim that has resulted from these services,” Casteneda said.
But Dr. Roger Seelye, an ophthalmologist from Owosso representing the Michigan Optometric Association, called online exams “dangerous.”
“Bad things happen to the eyes of contact lens wearers if they are not closely monitored by trained professionals who are examining their eyes under imaging and magnification significant enough to make the proper diagnosis,” Seelye said. “. . . It would be hard for me to believe that any one of you truly believes the FDA’s advised appropriate physician oversight could be what transpires over the 1-800 Contact Express Exam app, which is merely a visual acuity test.”
He said the cornea derives its oxygen from the atmosphere and so a contact lens blocks the oxygen supply to the cornea.
“Immediately, a contact lens changes the corneal physiology, structural integrity and the even the cornea’s clarity. The cornea becomes an oxygen-deprived structure under a contact lens and must have routine and regular physician oversight with proper equipment to identify early changes that would signify larger changes on the way,” Seelye said.
The bill was reported in a 16-3 vote. Voting no were Stone, Rep. Laurie Pohutsky (D-Livonia) and Rep. Christine Morse (D-Portage).
It Took A Viral Video For Couple To Get Mental Health Help For Son
It took a viral YouTube video for a Mt. Pleasant couple to get their adopted 15-year-old son into an adolescent, in-patient bed after he spent two weeks in a mid-Michigan emergency room because of a mental health crisis.
“The system of mental health is so broken. I’m learning to realize that it is OK to not be OK, and we are experiencing this with our son. But to get help when you are not OK, we are told some of the most ridiculous things I have ever heard in my lifetime,” Jay Gross said in the video.
One of the ridiculous things he heard: His insurance was “too good.”
The video went viral, they had multiple offers for help, including offers for placement in some facilities that had turned them down before.
Jay Gross and his wife, Jo Ann Gross, testified March 3 before the House Appropriations Subcommittee on Health and Human Services about the difficulties they had finding placement for their son.
Their son is “fighting some demons with his mental health” that arise from his biological parents, Jay Gross explained. “We are starting to see it materialize now.” Additionally, he said, they were alerted by the school that the son “also had been researching suicide on the Internet.”
The crisis began on Valentine’s Day and both a doctor and the son’s therapist advised the Grosses to get him to an emergency room, so they took him to the MidMichigan Medical Center – Gratiot in Alma.
And that is where he stayed while his parents looked unsuccessfully for placement in a psychiatric facility for two weeks. Finally, in frustration and with the reluctant agreement from his wife, Jay Gross shot the video in the parking lot as he prepared to spend another night in the ER with his son.
“My boy is in there and he is not getting anything right now except a lot of love from the nurses. Gratiot hospital, this ER has been phenomenal,” Jay Gross said. “. . . These guys have been off the charts amazing. We have not a gripe with the hospital, the nurses, the on-call doctors, nobody. They have treated us like royalty and just keep pushing us along, giving us strength. They are not the problem. The system is. And the system is breaking our hearts and it is hurting our kid. The system is abusing our child.”
Jo Ann Gross said hospital staff had reached the “last resort” for finding help for their son.
“And then other people told me and my husband as a last resort to get help for your child you need to abandon your child. You need to walk out of the ER and say you are done. And then CPS (Child Protective Services) is going to come in,” Jo Ann Gross told the committee today. “Abandon my child, no. That’s not on the table for us. I stood in the courthouse in Isabella County and I made a promise to Judge (William) Ervin that would not happen. I am there for our children. But now we are on the struggle bus and I keep getting brushed from one person to the other person.”
Had they abandoned their son, the couple said, they also likely would have been charged and have to go before a judge to explain it was a desperate act to get help.
Jay and Jo Ann Gross said that are not angry with anyone. But they wanted make the point that the mental health system is broken.
And they were pleased with reaction the received from the committee.
“I thought it was amazing . . . I saw eyes glassy,” Jay Gross said. “I saw tears. I saw heads bobbing, I saw a lot of heads shaking. But I saw humans. I didn’t just see legislators sitting there, I saw people that have families of their own, children of their own, grandkids . . . I saw people up there that cared today. We felt the attention was 100%.”
Jo Ann Gross said the hearing “completely changed my whole frame of thinking.” She’d come to Lansing prepared to fight for her son, and found lawmakers open and welcoming, not only during the hearing but before and after.
Committee Chair Mary Whiteford (R-Casco Twp.) said that in two years the state will have new systems in place that would have helped.
For one, she noted the state is implementing the Michigan Crisis and Access Line (MiCAL), which will go live in April, specifically designed to be a system for finding access to mental health beds and services for those in crisis.
“We also have the crisis and stabilization unit (CSU) licensing that is being implemented, and I would like to see that all over the state so that no person goes to an emergency room. They go to a CSU. They get an evaluation, if they need more admission, that can be initiated within 24 hours,” Whiteford said.
But she also encouraged legislators to continue working on improving the mental health system.
“You guys and countless other families are still struggling with this, so I just want everybody to keep your foot on the gas pedal because we are not done and only by working together—legislators, the department, the community, the executive—can we make generational changes,” Whiteford said.
Gordon Paid $155K On Way Out Under Deal Reached With Gov’s Office
Former Michigan Department of Health and Human Services Director Robert Gorrdon received a $155,506 payout as part of a separation agreement reached with Gov. Gretchen Whitmer’s office, according to the deal obtained by MIRS and first reported by the Detroit newspapers March 1.
Gordon and Whitmer’s chief legal counsel Mark Totten signed an agreement dated Feb. 22, roughly a month after Gordon resigned from state government. The paper said the agreement called for Gordon to get nine months of salary and that Gordon would release the state from any legal claims.
The deal also called for both Gordon and Whitmer’s office to keep the details of the resignation confidential, “unless required by law to release such information.”
The document said if a Freedom of Information Act request were filed referencing Gordon, the state would have to inform Gordon of it once it’s been determined the documents need to be released, provide him a description of the request, and provide access to the same documents at the same time and manner as the requestor.
The state also agreed to saying Gordon voluntarily resigned if any prospective employees inquired about him. According to The Detroit News, Gordon has been named a public service scholar at the University of Michigan Law School.
Gordon resigned from DHHS near the end of January, and Whitmer would not say why when questioned about it at a press conference.
MIRS learned shortly after that while Gordon signed the order allowing restaurants and bars to reopen, he didn’t like it.
House Oversight Committee Chair Steven Johnson (R-Wayland), in response to the news about Gordon today, said his committee “can’t keep up with all of the abuses from the Executive Branch” and that his committee may have to “hold multiple hearings a week.”
Rep. Graham Filler (R-DeWitt) had this to say in response: “You pledged transparency governor, and then signed a nondisclosure with the individual who made some of the most controversial, business closing decisions during your tenure.”
Feb COVID Cases Mark Third Straight Month Of Declining Numbers
The number of COVID cases reported during February marked the third month in a row the statewide cases have declined over a month’s time.
The 28,340 cases reported on days in February was fewer than the 33,764 cases reported back in April 2020, the height of the first wave of COVID-19 in Michigan and still when the most deaths were recorded by month.
The monthly cases have fallen from the 182,269 reported during November 2020 to 127,695 in December to 71,097 in January and now the 28,340 this past month.
February also saw 921 COVID deaths reported, the second consecutive month that saw a decline. There were 3,199 reported in December and 2,268 in January.
Today’s COVID numbers saw 1,569 more cases from today and Sunday and 12 deaths reported from the same period, for cumulative totals of 589,150 cases and 15,534 deaths.
On the vaccination front, Michigan is ranked in the top 10 of doses used – 87% – by The New York Times. The state is reporting 2.9 million doses delivered and 2.2 million administered as of Friday.
Adrian State Prison, McLaren Hospital Among Latest MIOSHA COVID Violations
The Gus Harrison Correctional Facility in Adrian was among the 23 workplaces cited by the Michigan Occupational Safety and Health Administration (MIOSHA) for COVID-19 safety violations, according to a press release Feb. 26.
The Michigan Department of Corrections (DOC) said in response that it “disagrees” with the MIOSHA citation and plans “to exhaust all appellate options available in order to defend against these unfounded claims.”
In response to a COVID-related fatality, MIOSHA said it investigated the prison and issued a $6,300 fine for various violations, which included:
– Not developing an adequate infectious disease preparedness and response plan.
– Not identifying all close contacts for employees who had received a positive result from a COVID-19 laboratory test.
– Not applying social distancing strategies on an operational level for employees who ate lunch.
– Not taking adequate measures to assure employees wore face coverings and practiced social distancing.
– Not adopting protocols to clean and disinfect the facility in the event of a positive COVID-19 case in the workplace.
According to the MIOSHA citation, a corrections officer reported a positive COVID test in April, but no interview was done with the corrections officer to identify close contacts. noted the corrections officer ate lunch daily with four others who tested positive after that first corrections officer reported a positive test.
Since none of the other officers were identified as close contacts, they weren’t required to self-quarantine and “thus potentially” exposed other employees to COVID-19.
DOC spokesperson Chris Gautz said MIOSHA has inspected its facilities before and “has never had any issues like the allegations announced (Feb. 26).”
Among the other 23 workplaces cited by MIOSHA today was McLaren Port Huron Hospital, which also received a $6,300 fine for a number of “serious violations,” including not conducting a daily self-screening protocol for employees, not keeping everyone on the worksite at least six feet from one another to the maximum extent possible, and not requiring face coverings to be worn when employees could not consistently maintain 6 feet of separation from other individuals.
With the additional workplaces cited today, MIOSHA is up to 126 places cited for COVID violations, although the agency said most employers are complying with state regulations, and fewer than 5 percent of employers investigated have received enforcement actions.
Cambensy Proposal Would Cap Insulin Co-Pays At $50
Rep. Sara Cambensy (D-Marquette), herself a Type 1 diabetic who has been taking insulin for 34 years, has watched the price go from $20 per vial to nearly $600, she told the House Health Policy Committee in late February.
“My co-pay was zero at the time. A little bottle like this takes me a month to go through. I’m on a relatively low dose,” Cambensy said Thursday. “Some people, it would take them three vials of this a month to use. But the cost now for any given insulin—there’s three different companies that offer it—is up to almost $580 a month for one vial. So if you need three vials a month and you don’t have any insurance, how do you pay for it?”
Cambensy was testifying in support of her HB 4346, which would cap insurance co-pays for insulin at $50 per month. Colorado was the first state to adopt such legislation last year, she said, and since then, 15 states have adopted similar legislation. Kentucky joined the late last month.
Cambensy introduced a similar bill last term and proposed then a $100 per month cap on insulin co-pays. She lowered the amount this time to $50 because other states that had $100 co-pays have since lowered the amount to $50.
Dominick Pallone, executive director of the Michigan Association of Health Plans, opposes the bill, although he said his group supports the goal of making insulin affordable.
“Despite the fact the original patent for insulin was developed over 100 years ago . . . and was sold for $1 apiece, a combined cost of $3 to the inventors, list prices for insulin continue to increase at well-documented rates. As you just heard, vials are often $500 to $600 for a 30-day supply. Congress has long debated this issue and it is only right that the Michigan Legislature turn its attention to addressing affordability issues for those with diabetes throughout our state,” Pallone said.
However, the bill does not address “the root cause” of the price increases, he said.
“Simply put, this legislation does nothing to take costs out of the system. Without removing costs, this proposal only serves to shift the cost,” Pallone said. “While unintended, HB 4346 in its current form is a form of government-mandated price-setting which amounts to an effectual tax on the fully insured health insurance purchasers in our state.”
Pallone contended the passage of the bill would only serve “to condone the predatory pricing practices of pharmaceutical companies who continue to increase the list price of insulin with no connection to cost or to increased quality.”
Rep. Mary Whiteford (R-Casco Twp.) asked if the bill would affect Medicaid or Medicare patients and was assured it would not. So the legislation would carry no cost to the state budget.
Cambensy said the Centers for Disease Control and Prevention (CDC) estimates about 11 percent of Michigan’s population has some form of diabetes.
Further, she said, the rate of deaths from diabetes has not been reduced significantly, despite a shift toward newer forms of insulin that have been developed.
“What some people think is going on is that because there are so many diabetics and because so many people need insulin that the revenue made from this drug and certainly the increase is going in to fund research into other drugs and other diseases and cancer,” Cambensy said. “Is it fair? I don’t know. But for the person that needs insulin and will within a matter of hours, days or a week die without it, it has become a serious problem.” Health Policy took testimony only this week and did not vote on the bill, which is part of the Speaker’s sweeping health care package introduced in February.