The Iowa Legislature could have saved lives in 2020.

However, for the second year in a row, they failed to do so. Last year, a bill was introduced that would have placed a $100 copay cap on insulin. The bill, HF2128, passed in the Iowa House, 98-1. But when the Legislature reconvened after its adjournment due to COVID-19, the bill was left to die. The copay cap would have addressed affordability for Iowans with certain insurance plans. It would not have been a solution for every patient with diabetes, but it would have been a step in the right direction.

That was just one failure to take action. In 2019, Sen. Carrie Koelker filed SF291, a bill for emergency insulin prescription refills in honor of my son Jesse, who died in 2018 because he could not afford his insulin. The bill called for a change in Iowa’s emergency medication law. The current emergency prescription law allows for 72 hours of a prescription to be filled at a pharmacy with an expired prescription. Since insulin is not packaged in 72-hour or fewer increments, the bill would fix legislation that prevents life-sustaining medication like insulin, epipens, and inhalers from being filled.

The 2019 bill would have ensured that a pharmacist could fill an expired prescription for drugs like insulin, inhalers and epipens, that cannot be dispensed in 72-hour increments. This would help avoid ER visits and save healthcare dollars. The bill passed both chambers — unanimously! But the Senate bill called for insurers to cover these emergency prescriptions, while the House bill would have left patients to pay the full cost of their medicine.

Without insurance coverage, one vial of insulin can cost around $300. Insurance lobbyists at the Iowa Capitol were opposed to an insurance mandate — despite the fact that covering insulin for patients who need it could save these companies from paying for emergency room visits or hospital stays for those suffering from diabetic ketoacidosis, which can cost thousands of dollars.

When the time came, it was more important for the Iowa House to protect insurance companies from having to pay for an emergency prescription that they would normally cover without hesitation, than to make these medications attainable. Some legislators think this bill would make healthcare more expensive, But I know that it is cost containment — and a lifesaver.

These were two totally different bills — one addressed accessibility, the other, affordability. Despite their differences, both would have saved lives. While our legislators tell us high drug prices are a “major priority,” their failure to do anything to address the insulin crisis tells a very different story.

My son passed away because no one had the courage to act to protect people like him from the greed of the pharmaceutical industry. Since his passing, I’ve advocated with T1International’s Iowa #Insulin4all Chapter to fight for insulin to be more affordable and accessible for those who need it. Across the United States, we’ve watched as legislators from both conservative and liberal states passed reforms to address drug corporations’ rampant price gouging for the insulin people like Jesse need every day to survive.

It’s past time for Iowa’s legislators to follow suit and do the right thing. In 2021, legislators must pass comprehensive legislation to protect the lives of Iowans with diabetes, like my son. There is no time to waste.

On Feb. 7, 2018, Janelle Lutgen’s son died after rationing his insulin. Since that time, she has been working with insulin4all to make insulin affordable and accessible. She resides in Bernard, Iowa.