ST. PAUL — State lawmakers on Monday, Sept. 23, took up the latest proposal to provide insulin to diabetics in need, but not before debating whether other plans should get higher priority.

The Senate Health and Human Services Committee took up a measure that would require drug manufacturers to foot the bill for insulin supplies for Minnesotans who can't afford the drug and who don't have state-sponsored health insurance. The panel didn't immediately act on the proposal but committed to continued work on the issue ahead of the 2020 legislative session.

The plan would require insulin manufacturers to supply the drug to patients with diabetes who are not already on a public health program and that make less than 400% of the federal poverty line. That would come out to roughly a $50,000 cap for individuals or $100,000 for a family of four.

Under the proposal, patients could fill out eligibility forms through the state's MNsure health insurance exchange website, which they could then submit to their doctors to obtain a 120-day refillable supply of insulin. They could be eligible through the program for one year before they would have to requalify.

Insulin manufacturers would need to provide free insulin as a condition of doing business in the state.

Lawmakers took up the bill months after an effort to provide a 90-day emergency supply of insulin for those with diabetes fell short in the Legislature. Drug manufacturers would've also been required to fund that program. And the conversation came days before House Democrats plan to issue a plan to address gaps in access to insulin.

Gov. Tim Walz has said he would call a special session if lawmakers could reach an agreement on how to resolve the issue.

Sen. Eric Pratt, R-Prior Lake, authored the Republican proposal and said it would help Minnesotans gain access to insulin before they are forced to ration the drug because of unaffordability. Insulin access advocates and others said the plan could create a good safety net, but it wouldn't catch those who need insulin right away.

“If we can make it affordable before that patient is in crisis, it seems to me that that’s a better approach than waiting until the patient is in crisis, providing them a 90-day supply and not having a robust answer after 90 days,” Pratt said. “Insulin doesn’t become any more affordable after day 91.”

Pratt's proposal gained both praise and criticism from lawmakers on the panel, who said it could provide a step in the right direction, but wouldn't solve the issue of providing insulin at the time of emergency.

“I look at this more as an urgency bill than an emergency,” Sen. Mary Kiffmeyer, R-Big Lake, said. “It’s an urgency bill that meets an urgent need for diabetics."

Pharmaceutical Research and Manufacturers of America, or PhRMA, in a letter to the committee, said the industry had worked to help patients afford their insulin and would continue working with lawmakers but had concerns about the proposal. Linda Carroll-Shern, deputy vice president of state advocacy, said the group had serious concerns about the program they viewed as "overly broad."

Insulin access advocates, too, criticized the proposal, saying it wouldn't provide a quick enough turnaround to help Minnesotans who need insulin within hours, not days.

“This plan as drafted along is insufficient in addressing the insulin crisis because it does not include a solution in emergency situations,” Lija Greenseid, an insulin access advocate from St. Paul, said. “This must be addressed.”

The proposal from Senate Republicans could be part of a broader approach, advocates and lawmakers said, but it shouldn't be the entire plan to improve access to emergency insulin. They suggested advancing legislation to provide insulin to those in emergent situations, then returning to Pratt's bill.

"I have no problem with doing an urgency bill during interim, I just feel like we should be dealing with the emergency first, then the urgency," Sen. John Marty, D-Roseville, said. "In the triage sort of fashion, you deal with the emergency then the urgency, then the sort of long term."