New law puts $25 cap on 30-day insulin supply for insured diabetics

“Huge savings” says Type-1 diabetic who testified in support of the law

SAN ANTONIO – Having lived with Type 1 diabetes since she was a child, Reva Verma, of Houston, said she was overwhelmed when the Texas Legislature passed SB 827 that put a $25 cap on 30-day supplies of insulin for those who are insured.

“It was almost surreal and there was nothing to take away from that moment,” Verma said, having testified many times in Austin and Washington, D.C. about the skyrocketing cost of insulin.

“It’s almost tripled in the last decade alone,” said Dist. 53 State Representative James Talarico, of Round Rock, who had an instrumental role in its passage.

Talarico said he was shocked to learn he was a Type 1 diabetic during his first campaign when he was only 28-years-old.

“I don’t think I’d had my blood sugar tested before. I didn’t even know what blood sugar was,” Talarico said.

He said as it is now, one in four diabetics in Texas are rationing their insulin, which could have life-threatening consequences.

“In the richest country in the world, we have folks who are dying because they can’t afford insulin,” Talarico said. “Hopefully with this bill, we are taking a big step toward preventing that from happening ever again.”

According to the American Diabetes Association, more than 11% of Texans have diabetes, and 34% are pre-diabetic.

Veronica De La Garza, ADA director of state government affairs, said it is “imperative to lower the out-of-pocket cost of insulin so people with diabetes can afford this life-saving medication.”

However, not all diabetics will be eligible for the $25 cap.

Talarico said, “The bill that we passed only applies to health insurance plans that are regulated by the state. In other words, plans that have authority over to regulated.”

Not all of them are, he said, so he urges those who are diabetic to check with their insurance carrier.

The law also stipulates the change only applies when those health plans kick in on January 1, 2022.

He also said it does not apply to those without insurance or who are on Medicaid.

But he said HB 18 creates a fund that will help provide “some of these critical medications like insulin at a discounted rate for those without insurance.”

He said the bill will go into effect this fall.

“As with any big piece of legislation, we have to work out the kinks as we go and as the law is implemented,” Talarico said.

He said both laws are the first steps toward the eventual goal, “Free insulin for every single Texan who needs it.”

Reva Verma said the ever-rising insulin prices were hurting her and the cost of insuring her employees.

But now the law has been enacted, she said, “At least it gives people the opportunity to predict the cost of what they can expect their medication to be.”

About the Authors:

Jessie Degollado has been with KSAT since 1984. She is a general assignments reporter who covers a wide variety of stories. Raised in Laredo and as an anchor/reporter at KRGV in the Rio Grande Valley, Jessie is especially familiar with border and immigration issues. In 2007, Jessie also was inducted into the San Antonio Women's Hall of Fame.

William Caldera has been at KSAT since 2003. He covers a wide range of stories including breaking news, weather, general assignments and sports.