Emergency insulin bill heard in Ways and Means  2/19/20

Emergency insulin bill heard in Ways and Means 2/19/20

February 20, 2020 1 By Jose Scott


BUT ON THE FIRST BILL AND THAT WE’RE TAKING UP A IS WITH POPULARLY KNOWN AS THE INSULIN BILL HOUSE BILL 3100 BY HOWARD AND WE CAN HAVE THE MOTION A REPRESENTATIVE JOE AT LEON THAT’S TO BUY HEALTH.>>YES; YES; IT CERTAINLY DID THANK YOU. MISTER CHAIR. SO I MOVE THAT HOUSE FELT 3113 GROSSMAN TO BE RECOMMENDED TO BE PLACED ON THE GENERAL REGISTER. THE MOTION AS A BEFORE US. ANY A DISCUSSION SEEN MISTER CHAIR ALL THAT’S RIGHT. WE DON’T NEED TO VOTE YET. YEAH.>>I WHERE I WAS PHYSICALLY NOT ABOUT THE DIVISION REPORT FOR THE BILL IS BEFORE OK; THANKS NEW SESSION WILL CLAIM TO GET A USED TO IT WE DO HAVE AN AMENDMENT HOWEVER THAT A 7 HELP YOU REAP SOME ELSE MISTER CHAIR I’LL MOVE THE. 3108 13 DASH ONE AMENDMENT AND MY UNDERSTANDING THIS MEME IT IS TOO PUT IT IN LINE WITH THE FISCAL NOT THAT WE OUT THAT THEY GOT YESTERDAY; OKAY AND THE DISCUSSION ON THAT MOTION. THE SCENE AND THEN ALL THOSE IN FAVOR SIGNIFY BY SAYING AYE AYE OPPOSED MOTION PERIOD. THAT’S IN HOWARD ON THE BILL AS AMENDED MISTER CHAIR; THANK YOU AND THANK YOU THIS IS THE ALEX SMITH INSULIN AFFORDABILITY ACT IN MANY MEMBERS HERE HAD A CHANCE HERE THIS BILL AS IT’S MOVED THAT THROUGH THE PROCESS. LAST YEAR AND THIS YEAR AS WELL. AT ITS HEART THIS BILL IS ABOUT CREATING A SAFETY NET SO THAT NO MINNESOTA LOSES THEIR LIFE BECAUSE THEY CAN’T AFFORD THE UNSULLIED TO SURVIVE.>>WE HAVE ALL HEARD THE STORY OF ALEX SMITH FROM NICOLE IN JAMES. AND IT’S HEARTBREAKING THAT SOMEONE COULD LOSE THEIR LIFE SIMPLY BECAUSE PICKING UP ENOUGH MONEY IN THEIR BANK ACCOUNT THAT DAY TO FILL THEIR INSULIN PRESCRIPTION. AND SINCE LAST SESSION TO MORE MINNESOTANS HAVE LOST THEIR THAT’S WHY WE’RE HERE TO STAY AND GRATEFUL FOR THE COMMUNITY HERE THIS BILL TO MOVE FORWARD WITH THE URGENCY OF THE SITUATION. THIS DESERVES IN BROAD STROKES THIS BILL WOULD CREATE A PATH. SO THAT ELIGIBLE MINNESOTANS IN THOSE ARE FOLKS MOST AT RISK OF RATIONING THEIR INSULIN WOULD BE ABLE TO GET A EMERGENCY FILL OF INSULIN AT THE PHARMACY. WHEN THEY NEED IT IN ADDITION; WE WOULD CONNECT MINNESOTANS TO LONG-TERM RESOURCES TO NAVIGATOR TO MAKE SURE THAT IF THEIR EXISTING PUBLIC PROGRAMS WE CAN SECURE GET THEM UNDER THOSE PROGRAMS AND ALSO CONNECT THEM TO TO WHAT OTHER AFFORDABLE CARE OPTIONS MIGHT BE AVAILABLE TO THEM WE ARE UTILIZING. THE 3RD PARTY ADMINISTRATOR TO PROCESS THE CLAIMS IN THE PHARMACY LEVEL THAT ALLOWS US TO USE THE EXISTING INFRASTRUCTURE IN PLACE PHARMACIES UTILIZE SO THAT WE CAN SET A PROGRAM THAT QUICKLY AND GET IN SWING INTO THE HANDS OF PATIENTS WHEN THEY NEED IT. THIS BILL IS FUNDED THROUGH A COMBINATION OF PUBLIC FUNDS AND A FEE AT INSULIN MANUFACTURERS. THERE’S ABOUT A MILLION DOLLARS IN PUBLIC COST THAT ARE LARGELY TO SET THE PROGRAM UP. THROUGH THE DEPARTMENT OF ADMINISTRATION AND THEN 2 MEN SURE AND WE HAVE A WE WILL HAVE A FEE ON INSULIN MANUFACTURERS. THEY’RE JUST 3 MANUFACTURERS THAT CONTROL VIRTUALLY THE ENTIRE GLOBAL SUPPLY OF INSULIN WHO WOULD BE ASSESSED THIS BE BASED ON THE PROPORTION OF THEIR SHARE OF THE AND THE THE LARGEST DRIVER OF THAT COST IN THIS CASE CANNOT BE SIMPLY THE COST OF INSULIN. AND HAPPY TO ANSWER ANY MORE SPECIFIC QUESTIONS MISTER CHURCH THAT FOR ME. REPRESENT SPECTRUM.>>THANK YOU MISTER CHAIR HOWARD WHEN WE’RE WHEN YOU ARE IN THE. JUDICIARY COMMITTEE WE TALKED ABOUT SOME DATA PROVISIONS AUDIT TRAILS AND AND SOME OTHER ISSUES THAT I THOUGHT SHOULD PROBABLY BE IN THIS BILL AND SO THOSE WE PLAN ADDING THOSE IN ON THE FLOOR BECAUSE I DON’T SEE THAT IN THE PRESENT BELL. HOWARD.>>MISTER CHAIR OF SHIPS GOT WE DID AT THE AMENDMENTS THAT YOU OFFERED IN JUDICIARY AND THANK YOU FOR. THOSE GOOD THAT CONSUMER PROTECTION PROTECTION AMENDMENTS; I’VE GOT SOME CONVERSATIONS WITH THIS SPECIFIC DATA SET ISSUE AND DON’T HAVE THE SPECIFIC DATA SET INCLUDED IN THE BILL BUT HAPPY TO CONTINUE THE CONVERSATION BEFORE OR ON THE FLOOR.>>IF THAT’S WHAT YOU’RE ASKING. THANK YOU. MISTER CHAIR; AND REPRESENTATIVE HOWARD COULD YOU POINT ME IN THE END OF THIS THE DURATION OF THE BILL THAT WE HAVE BEFORE US WHERE THOSE DATA PROVISIONS ARE REGARDING THE AUDIT TRAILS AND THE ROLE BASED ACCESS.>>BUT MISTER CHAIRMAN I’M JUST GLANCING THROUGH HERE. I BELIEVE THAT AMENDMENT IS INCLUDING A COUPLE DIFFERENT PLACES. AND 9 DASH 1; 5 WE HAVE INFORMATION ABOUT THERE WAS A SPECIFIC AMENDMENT ALSO TO THE 3RD PARTY CONTRACTOR PIECE THAT INCLUDED. THAT’S IN SCOTT. THANK YOU.>>I DON’T SEE THE AUTO LANGUAGE IN THIS SECTION AND ON 9.1 5 AND FOLLOWING. SO EVIDENTLY MUST BE SOMEWHERE ELSE BECAUSE I DON’T. I DON’T SEE IT HERE WITH MISTER CHAIR OF JUST GOT FOR YOU.>>IT’S TIME TO GET SOME INFORMATION OR YOU COULD COME UP TO THE TABLE AT THE NECESSARY.>>BUT MISTER CHAIR JUST GOT THE AMENDMENT THAT WE PASSED IN JUDICIARY’S UNDERSTANDS INCORPORATED THAT’S THE EXTENT OF WHAT’S INCORPORATED HERE IF THERE IS THE ADDITIONAL PIECE BUT I BUT THE FALL OFF LINE AND MAKE SURE THAT WE I HAVE A CONVERSATION. ELSE ON THE COMMITTEE HAS A.>>AND THANK YOU MISTER CHAIR JUST WANTED TO KIND OF ALONG WITH WHAT I’M REPRESENT A POWER TO SAY BEING IN IN THE HEALTH AND HUMAN SERVICES FINANCE DIVISION; WHICH WAS THE LAST STOP WE DID ADOPT AN AMENDMENT. THIS WAS AS YOU KNOW AS MEMBERS KNOW THIS BEEN ONE OF THOSE BILLS IT’S GONE TO VARIOUS COMMITTEES IN VARIOUS FORMS WITH CLONE BILL SEN. WE DID PASS A REALLY GOOD AMENDMENT IN JUDICIARY AND WE ADOPTED THAT SAME AMENDMENT I UNDERSTOOD THAT IT WAS IN OUR BILL SO IF IT ISN’T IN HERE IT WOULD BE A MISTAKE; BUT I THINK IT IS THIS HAS BEEN ENGROSSED SO. I IT IT SHOULD BE IN HERE AND FROM THERE I THINK MISTER CHAN PROBABLY WOULD BE BEST ONE TO ANSWER; WHERE’S THE SPECIFIC PIECES OF THE CAR. HE’S JUST COME FORWARD SO. A SEARCH ON MAY MAY BE BE MORE EFFICIENT IF YOU DON’T MIND JUST>>YOUR DAY ON I ASSUME YOU HEARD THE QUESTION WHITE HOUSE; I’M JUST MISSED THE TREND MEMBERS. I THINK THE QUESTION WAS WHETHER THE LANGUAGE THAT WAS PUT IN IN CIVIL LAW IS THIS IN THIS UNDATED PRIVACY THAT AMENDMENT WAS PUT ON AS RECIPE THING SAID IN THE HHS FINANCE COMMITTEE AND THAT TRUCK AND FIND EVERY SINGLE PIECE BUT BUT FOR EXAMPLE AND IF YOU GO TO PAGE TO PAGE 2 9; 2.6 THAT THAT SOME OF THE LANGUAGE FROM THE EVENT MEANT ANOTHER PIECE FROM THE AMENDMENT WOULD BE ON PAGE 9. 9 TO 10 THROUGH. TO 14. AND THERE’S ALSO SOME DATA BEGINNING ON PAGE 9 LINE 15. 2 9.23. SO THE AMENDMENT WAS BUZZING GROWS INTO THE BILL.>>SINCE THANK YOU MISTER CHAIR AND I’LL CONTINUE TO LOOK THROUGH THE BILL BUT AND STILL NOT SEEING THE AUDIT ROLLING JUST ABOUT KEEP LOOKING.>>ANYBODY CAN BEAT ANYBODY WELL RIGHT NOW GIVE YOU GUIDANCE ON THE MATTER WITH JUST THE REPRESENT SCOTT PEOPLE PEOPLE. OK ANY OTHER.>>THANK YOU MISTER CHAIR OR A REPRESENTATIVE YOU HAVE TO PARTITIONS IN THE BILL ONE IS FOR EMERGENCIES. I AS I UNDERSTAND IT AND LISA CORRECT ME IF I’M WRONG. WHAT IS THE MAX OUT OF POCKET COST TO PURCHASE UP AND IN THE EMERGENCY. THIS ONE SIDE OF YOUR BILL.>>MISTER CHAIR REPRESENT ABOUT HOW THE ELIGIBILITY IS STRUCTURED IN THIS BILL IS THAT. IN BROAD STROKES WHAT WE’RE TRYING TO CAPTURE THE ARE FOLKS THAT THEY HAVEN’T COME THAT PUTS THEM OUTSIDE OF BEING ACCESSIBLE FOR YOU. MOST PUBLIC ASSISTANCE PROGRAMS WHERE THEY WOULD HAVE ACCESS TO AFFORDABLE AND SO ON; BUT THEY’RE NOT MAKING SO MUCH MONEY THAT HE CAN AFFORD THOSE LARGE OUT OF POCKET COSTS IF THEY’RE EITHER UNINSURED ON A HIGH DEDUCTIBLE HEALTH PLAN AND SOME CUTS TO MEDICARE. THE ELIGIBILITY IF YOU. OUR IF YOU’RE CO PAY HIS $50 OR LESS FOR INSULIN YOU’RE NOT ELIGIBLE. BECAUSE THE PRESUMPTION IS THAT YOU DO HAVE. ACCESS TO AFFORDABLE INSULIN. IF YOU ARE IN THOSE INCOME RANGES IN YEAR. COPIOUS BP DOLLARS OR GREATER YOU COULD BE FOR THE EMERGENCY IN SWIM PROGRAM AT 500% OF THE FEDERAL POVERTY GUIDELINES. AND THE LONG-TERM INSULIN PIECE WE SET THAT A LITTLE MORE WE’RE AT 400% THE FEDERAL POVERTY GUIDELINES AND THAT’S A PRODUCT THAT WORKING IN TRYING TO ALIGN TO GET BIPARTISAN AGREEMENT WITH THE SENATE WHICH IS WHERE THEY ARE AT AN ER LATEST DISCUSSIONS. REPRESENTATIVE HARD TO UNDERSTAND THE PARAMETERS FOR.>>HOW THE DETERMINATION GOES TO THE CORE PAY BUT SOMEWHERE ALONG THE LINE I THINK FOR THE SPILL FOR 5 TIMES I HAVEN’T GOTTEN THEIR ANSWER IN TERMS OF IF YOU NEED INSULIN. ON AN EMERGENCY BASIS. WHAT IS MY OUT OF POCKET COSTS TO GET A 3 MONTH OR A ONE-MONTH SUPPLY OF INSULIN.>>MISTER CARE ABOUT LIKE THAT.>>COST WOULD BE A $30 COPAY FOR A 30 DAY SUPPLY OF INSULIN; SO IT. YOU’RE ALSO BE ABLE TO ACCESS A 90 DAY SUPPLY OF INSULIN THAT WOULD BE $90 FOR THAT SUPPLY OF INSULIN; SO IT’S STRUCTURES TO COPE AND AGAIN THAT’S AN AREA WHERE YOU KNOW IN OUR. MY WAY I DON’T I WANT TO HAVE ANY BUT IN THAT INTEREST OF TRYING TO COME TO CONSENSUS WITH THE SENATE IS WHERE WE HAVE A COPAY $30.>>REPRESENT OUR WHAT IS THE OUT OF POCKET COST FOR THAT LONG-TERM PROGRAM.>>MISTER CHAIR REPRESENT ABOUT GREAT THE IF YOU QUALIFY FOR THE LONG TERM PROGRAM. YOU ARE RECEIVING A MONTHLY SUPPLY BEEN SAYING AT NO COST FOR UP TO A YEAR. SO HOW THAT COULD PLAY OUT TO YOU GET YOUR EMERGENCY. RE FELL AND THEN YOU’RE CONNECTED WITH THE NAVIGATOR ENSURE WHO CAN HELP ASSESS YEAR. A LONG-TERM OPTIONS AND LET’S SAY TO THAT YOU LEARN THAT COME OPEN I COULD QUALIFY FOR A PLANNED ON THE MAJOR CHANGE THAT WOULD CAP MY CO PAYS IF YOUR DOLLARS OR YOU’D BE ABLE TO GET A SUPPLY BEEN SOMEWHAT SAY YOU YOU FLIGHT IN JUNE HE BE ABLE TO GET THAT SUPPLY UP IT OPEN TO THE ELEMENTS AND WHEN YOU CAN GET IT WRONG AND HAVE AFFORDABLE COVERAGE ON THE EXCHANGE. SO CAN YOU WALK ME THROUGH THE PRACTICAL PROCESS. THE A A DIABETIC WOULD NEED TO FOLLOW TO RECEIVE.>>EMERGENCY SUPPLY OF INSULIN AND AND I WOULD APPRECIATE UNDERSTANDING. IF THERE ARE CHANGES TO WHERE THEY MIGHT HAVE TO GO IN ORDER TO REALIZE. EMERGENCY SUPPLIES. ENOUGH IN THE ENVIRONMENT THAT YOU DESCRIBE. TROOPERS ARE MISTER CHAIR UP IN ALL RIGHT; THAT’S A REALLY GOOD QUESTION AND ONE THAT SORT OF BEEN AT THE HEART OF.>>HOW ARE STRUCTURED IN THIS WE WANT TO DO IS MAKE THE PROGRAM THAT IS VERY RESPONSIBLE FOR THE PATIENT. ALLOWS THEM TO ACCESS THEIR MEDICATION HOW THEY WOULD NORMALLY SO HOW THIS STRUCTURE THAT IF YOU ARE A PATIENT AND YOU CANNOT AFFORD YOUR NECK SUPPLY OF INSULIN; YOU HAVE A HIGH-DEDUCTIBLE HEALTH PLAN YOUR OUT OF POCKET COSTS WE’RE GOING TO BE 3 $400 YOU’RE ABLE TO APPLY ONLINE. AND ENSURE WEBSITE WILL BE A A BASIC APPLICATION THAT ALASKA SERIES OF QUESTIONS. THAT BASED ON YOUR ELIGIBILITY AND YOU KNOW INCOME LEVELS ATTESTING THAT YOUR PICK THEY SEE AN EMERGENCY AND INSTANTANEOUSLY YOU’LL GET A RECEIPT ESSENTIALLY FROM ENSURE THAT’S IN ONE HAND AND WITH THAT AND ABOUT PRESCRIPTION AND THAT YOUR PHARMACIST. I MEAN IT CAN BE YOUR COMMUNITY PHARMACISTS WHERE YOU HAVE YOUR INSULIN ON FILE. YOU KNOW TO TO TAKE THOSE 2 BITS OF INFORMATION AND THERE YOU CAN GET YOUR SON EMERGENCY SO APPLY THAT INSULIN AND I JUST WANT SPECIFICALLY. THE IMPORTS OF THIS IS TO ALLOW PATIENTS TO ACCESS. THEIR INSULIN WHERE THEY WOULD NORMALLY GO. WE SHOULDN’T BE FORCING PATIENTS THAT GO TO THE EMERGENCY ROOM; IT’S AT RIGHT TIME. THAT’S PART OF THIS BILL IS TO CREATE THAT NETWORK SO THAT MINNESOTANS CAN GO WHERE THEY NORMALLY GO THE COMMUNITY PHARMACY TO ACCESS THEIR MEDICATION. MISTER CHAIR AND YOU YOU IT READ IT TO PIECES OF PAPER THAT SOMEONE NEEDING TO US RELY AS AN EMERGENCY SUPPLY ONE IS THIS A.>>DOCUMENTATION FROM THE WEB SITE THAT’S GOING TO BE RUN BY MEN SURE. AND THE OTHER ONE IS A VALID PRESCRIPTION. A VALID PRESCRIPTION WHAT IF THEY DON’T HAVE A VALID PRESCRIPTION AND THEY JUST BROKE THE LAST BILE OF. AND IT’S FRIDAY NIGHT. MISTER CHIPS AT ALL; BUT THAT’S ANOTHER VERY GOOD QUESTION.>>THE LEGISLATURE ACTUALLY THIS LAST SESSION ONE OF THE THINGS WE DID PASS WAS REPRESENTED BONNER’S BILL. IF YOU HAVE AN OUT OF DATE PRESCRIPTION FOR A LIGHT. BUT LIFE NECESSARY MEDICATION; YOU CAN GET THAT REFILLED SO BECAUSE OF THAT LEGISLATION YOU COULD GET A REFILL NOW IF. YOU ARE BILL IS REALLY CONSIDERED WITH THAT COST BARRIER IF YOU CAN ACCESS YOUR MEDICATION BECAUSE OF COST THIS PROGRAM EXISTS TO MAKE SURE THAT YOU KNOW IF YOU’RE IN A SITUATION LIKE ALEC. WHERE HE AT $1300 KOSTER IS INSULIN; YOU KNOW $1000 HIS BANK ACCOUNT THAT’S WHAT THIS BILL IS AIMING TO LEAVE IT; BUT BECAUSE OF THE BIPARTISAN WORK THIS PAST SESSION. YOU SHOULD BE ABLE TO GET A REFILL YOUR PHARMACY IF YOU HAVE AND HOW TO GET PRESCRIPTION AND IN THAT SITUATION THE BROKEN VILE. MISTER CHAIR TOLD ME THANK YOU.>>WE ARE RELYING ENSURE AND THE THIS WILL NOT SUBSTANTIATES THAT ALL THE PARTICIPANTS TO THIS PROGRAM THEY ASSUME WILL UTILIZE A SERVICES A MENTOR ELECTRONICALLY. WHAT A MENSCH OR ISN’T RIGHT. INSURERS PAST. WHO WILL BE LIABLE IF THEY CAN’T REALIZE THAT PIECE OF PAPER. AND THEY DIE.>>MISTER CHAIR ERUPTION OF A ONE THING I WOULD CLARIFY IS WE’RE NOT I DON’T WANT TO CONFLATE WE’RE REQUIRING THAT MEN SHOULD BUILD THAN IT IN CHURCH EXCHANGE ET CETERA. IT’S REALLY A BASIC FORM AN APPLICATION SERIES OF 6 QUESTIONS OR SO. THAT FOLKS FILE AND THE OTHER PIECE THE BILL INCLUDES IS INABILITY FOR A PHARMACIST TO ASSIST A PATIENT WITH A PAPER APPLICATION THAT SEPARATE TO MAKE SURE THAT THAT SITUATION DOESN’T HAPPEN. I THINK MISTER CHAIRMAN A.>>REPRESENTATIVE WE RECEIVED QUITE QUITE EXTENSIVE FISCAL NOTE ON THIS ABOUT 24 HOURS AGO. I’M WONDERING IF YOU CAN A COUPLE OF POINTS IN TERMS OF. COST AND RELEVANT ASSUMPTIONS THAT MEMBERS OF THE COMMITTEE MAY NOT BE FAMILIAR WITH.>>AND OUR MISTER CHAIR PERCENT DROP HE’S THAT I WOULD POINT TO. THE AMOUNT THAT WILL BE ASSESSED A MEANS FOR MANUFACTURERS. IN FISCAL YEAR 2020 WANT TO BE MILLION. AND A COUPLE THINGS ABOUT THAT FIGURE. IT RIP CHOIRS THAT A SERIES OF ASSUMPTIONS BEING MADE ABOUT UTILIZATION FOR THIS PROGRAM; IT IS A NEW PROGRAM; WE DON’T KNOW HOW MUCH IS GOING TO BE THE ASSUMPTION IN THIS FISCAL ESTIMATES THAT 70% OF FOLKS THAT ARE ELIGIBLE FOR THAT. THE PROGRAM WILL UTILIZE AND. CLEARLY THERE HAS TO BE SOME SORT OF ESTIMATE OF JUST CALL OUT THAT WHEN THIS BILL PASSED THE HOUSE LAST SESSION THAT WAS ASSUMED TO 25%. AND SO. I SUBMIT THAT THEY BELIEVE THAT NUMBER IS SIGNIFICANTLY HIGHER THAN WILL BE THE UTILIZATION RATE. HOWEVER WHAT WE’VE DONE IN THIS BILL IS INCLUDE LANGUAGE THAT WORD BASICALLY A AT THIS IS THAT A LOT SO IN THAT FIRST YEAR IF THE FI DID COLLECT TOO MUCH MONEY WE WOULD GET THAT MONEY BACK TO THE DRUG COMPANIES. AND THE OTHER THING IT HIGHLIGHTED BUT THAT NUMBER IS THE LION SHARE THAT $38 MILLION IS SIMPLY THE COST OF INSULIN. AND. IT IS NOT THE TRUE COST TO THE MANUFACTURERS BECAUSE HOW THIS IS STRUCTURED IS YOUR INSULIN MANUFACTURE MATE; PRODUCE THE VIAL OF INSULIN FOR $7 WHICH SOME STUDIES INDICATE THAT’S THAT COST THEY WILL SELL AT THE WHOLE SO GREAT. FOR SEVERAL $100 WITH THIS BILL IS BASICALLY ASKING IS THAT THEY BUY BACK THE INSULIN THAT THEY THAT THEY PAID FOR SO THE TRUE COST OF THE MANUFACTURERS SIGNIFICANTLY LESS THAN THAT THAT NUMBER THAT ARE THOUGH SOME OF THE HIGH LEVEL NUMBERS THAT ARE THEY’RE HELPFUL.>>REPRESENTATIVE HOWARD THE YEAR BY ANY OF US THE $76 MILLION CERTAINLY. I MEAN EVEN BY THE NFL STANDARDS THAT A LOT OF MONEY. YOU HAVE ANY COMMENTS ON THAT THE 76 MILLION THAT WE HAVE DATA FROM THE DEPARTMENT OF HEALTH THAT SAYS THAT WE HAVE APPROXIMATELY 2 2800 PEOPLE IN THE STATE OF MINNESOTA SUFFERED FROM DIABETES AND DON’T HAVE INSURANCE. THE POPULATION YOU’RE SEEKING TO ASSIST US POTENTIALLY LARGER THAN THAT BUT THE MENGER $76 MILLION BIENNIUM IT IS NOT KIND OF A LOT AND IT’S THAT KIND OF A A LOT. MISTER CHAIR REPRESENT GRAS FLOAT.>>ONE THING I WOULD HIGHLIGHT. FOR MEMBERS IS AGAIN THIS IS A YOU WOULD BE ASSESSED AND MANUFACTURES NOT A COST BORNE BY TAXPAYERS. WE DON’T BELIEVE THAT MINNESOTA TAXPAYER SHOULD BEAR THE RESPONSIBILITY OF ADDRESSING THE CRISIS CREATED IN LARGE PART BY THE HIGH COST OF INSULIN IN SOME WAYS; WHAT THAT NUMBER REFLECTS IS THE. THE PRICE OF INSULIN IS COMPLETE WHEATLEY UNAFFORDABLE FOR TOO MANY MINNESOTANS SO TO ME THAT’S WHAT THE NUMBER OF FLEX ITS THE COST OF THE INSULIN AND AS I MENTIONED IT WON’T BE THE TRUE COST BORNE BY THE INSULIN MANUFACTURERS.>>AND MISTER CHAIRMAN REPRESENTATIVE HOWARD I DON’T I DON’T KNOW WHERE THE INSULIN MANUFACTURERS ARE SUPPOSED TO GET THE MONEY FROM THEY DON’T HAVE A PHARMACEUTICAL FERRY. IT IS GET THE MONEY FROM THE US POST MONEY ON THEM. AND THAT COMES FROM THAT COMES FROM PEOPLE WHO ARE BUYING MEDICINE. THIS IS THE SAME SHIP THAT WE’RE SEEING FROM THE REBATE SIDE THINGS WHERE CUSTOMERS ARE PAYING EXTRAORDINARY RATES AND THE FARMS TO THE INSULIN MANUFACTURERS AREN’T GETTING THE MONEY WE HAVE THE DATA THAT IT’S NOT GOING INTO REBATES AND IT’S BEING USED TO INSURANCE COMPANIES AND THOSE IN THE SUPPLY CHAIN ARE GOBBLING UP THAT MONEY BUT I DO WANT TO STAY FOCUSED ON THE ON THE FISCAL NOTE; FIRST OF ALL ON THE FISCAL NOTE AGE 15. THE 4TH PARAGRAPH DOWN MENTIONS THE THE 70% SO THE NUMBER THAT THEY LIST HERE AT THE NUMBER OF ELIGIBLE INDIVIDUALS FOR THIS PROGRAM. THE CORRECT IN SAYING THAT SO THE 16;600 INDIVIDUALS IS THAT A NUMBER THAT YOU AGREE WITH OR DO YOU DISPUTE THAT NUMBER THAT’S CONTAINED ENOUGH AND THE SYSTEM OUT. MISTER CHAIR PERCENT DROP BELOW.>>HIM TO COME UP WITH THIS NUMBER YOU HAVE TO ESTIMATE I WOULD CONTEND THAT THAT NUMBER IS HIGH FOR THE UTILIZATION WOULD YOU LEAST UTILIZATION WILL BE A COUPLE THIS IS YOU KNOW THE FIRST YEAR WE OPERATE THIS PROGRAM WE ARE GOING TO HAVE A LIFT TO MAKE SURE THAT MINNESOTANS KNOW THAT AVAILABLE TO THEM. WE DO INCLUDE SOME RESOURCES PREFER A PUBLIC RELATIONS AND YOU KNOW FOR PERCENT OF REASONS THAT NUMBER SEEMS HIGH TO BE BUT AGAIN THAT’S WHY WE INCLUDED TO SETTLE UP LANGUAGE SO IN SOME WAYS THE FEE IS GOING TO COLLECT WHAT’S GOING TO COLLECT IN THE IMPACT IS GOING TO BE WHO UTILIZES THE PROGRAM. AND BECAUSE WE HAVE THAT SETTLE UP LANGUAGE WHERE IF HE DOESN’T WILL PAY THAT MONEY BACK TO THERE’S NO MENTION THIS IS KIND OF A FIRST YEAR PROBLEM. ONCE WE RAN THE PROGRAM AND AFTER YEAR ONE WE WILL HAVE A BETTER SENSE OF WHAT THOSE POSSIBLE BE.>>REPRESENTATIVE HOWARD WANT TO BE CLEAR WHEN YOU SAY THE NUMBERS. HI ARE YOU REFERRING TO THE 70% NUMBER THE 16;600 NUMBER OR BOTH. AND WHEN MISTER CHAIR UP TO PROP UP TO 70%. MISTER CHAIRMAN MEMBERS OF OUR 16;600 INDIVIDUALS. MISTER CHAIR PERCENT GRAS FLOAT IN THIS. YOU MAY BE REFERRING TO THE 23;000 THAT THAT 23;700 NUMBER IS OF THOSE ELIGIBLE AND THAT WE GET TO THE 60;600 THE 70% FIGURE BUT IN TERMS OF THOSE THAT ARE TO HIGHLIGHT THOSE. POPULATIONS IT’S REALLY THE UNINSURED. FOLKS THAT ARE ON HIGH DEDUCTIBLE HEALTH PLANS THAT HAVE HIGH OUT OF POCKET COSTS AND FOCUS ON MEDICARE THAT HAVE HIRED A POCKET COSTS AND. THIS FISCAL NOT ESTIMATES WHAT THOSE POPULATIONS WILL BE. AND WE HAVE A MECHANISM IN PLACE WITH THE FEET TO COLLECT WHAT WE ACTUALLY NEED. MISTER CHAIRMAN REPRESENT OUR I JUST WANT TO KNOW IF YOU THINK IT’S AN ACCURATE. MISTER CHAIR OF THE GRAPH I DON’T HAVE AS MUCH OF AN ISSUE WITH THAT NUMBER THAT IS THE 70% NUMBER. MISTER CHAIRMAN I JUST WANT TO THINK THAT I MISTER CHAIR FOR ANOTHER NOTHING TO PLAY COY. IT’S JUST AN ESTIMATE; YOU KNOW WHERE I IT I THINK IT’S A FAIR ESTIMATE; BUT WE WON’T KNOW UNTIL THAT THE PROGRAM MAKE IT ACTUALLY EXISTS IN. WE SEE HOW MANY PEOPLE UTILIZE THE PROGRAM WE STRUCTURED IN A WAY THAT YOU KNOW. THAT HE WILL COLLECT WILL COLLECT BASED ON HOW MANY PEOPLE ACTUALLY USE THE PROGRAM SO IN SOME WAYS THE ESTIMATES BASED ON HOW WE CRAFTED THE BILL AREN’T AS IMPORTANT AS MAKING SURE THAT WE GET IT RIGHT AT THE BACKING.>>MISTER CHAIRMAN THANK YOU AND A REPRESENTATIVE HOWARD SO I’D LIKE THIS POINT LIKE TO GO SECTION SUBDIVISION 3 OF THE BILL AND THIS IS ON PAGE 2. THIS IS THE SUBDIVISION HAVING A CHALLENGING BILITY REQUIREMENT. AND FIRST OF ALL I WANT REFERENCING THE FISCAL OUT AS WELL OF THE BILL AS WELL THE BELL. YOU’RE IN MINNESOTA CARE MEDICAL ASSISTANCE JUST DOESN’T APPLY TO YOU. MISTER LEWIS AND MISTER CHAIRMAN REPRESENTATIVE HOWARD P TO EXPLAIN WHY. MISTER CHAIR OF THE OUTFLOW.>>YOU’RE ACCESSING CARE UNIT. THOSE PRAGUE PROGRAMS YOU ACCESS YOU ARE GETTING THAT AFFORDABLE INSULIN EITHER AT NO COST OR VERY LOW COST.>>AND MISTER CHAIRMAN WROTE ON THE ALSO SPECIFICALLY EXCLUDE THOSE WHO ARE ELIGIBLE UNDER THE INDIAN HEALTH SERVICES IS THAT CORRECT THING QUESTION WHY IS THAT. MISTER CHAIR FOR ABOUT THE SAME ANSWER. YES. AND MISTER CHAIRMAN AND REPRESENTATIVE HOWARD WE ALSO SEE YOU HAVE A 500% FEDERAL POVERTY GUIDELINE HERE. RIGHT NOW IS A CRACKED OR NOT THE 400% FEDERAL POVERTY LEVEL ALL 3 MAJOR MANUFACTURER.>>MISTER CHAIR FOR RAFFLE THAT’S NOT THE THE 3 INSULIN MANUFACTURERS HAVE SOME LEVEL OF SUPPORT FOR MINNESOTANS AT THAT 400% BUT A TRUE. EMERGENCY PROGRAM THAT SOMEBODY IS AN EMERGENCY THEY WALK INTO A PHARMACY; THEY NEED TO SURVIVE INSULIN. I’M NOT ALL 3 HAVE THAT I BELIEVE ONE AS OF JANUARY 1ST INTRODUCED TO A PROGRAM LIKE THAT. AND WE’VE HEARD OF THE MYRIAD ISSUES IN THE IMPLEMENTATION OF THAT THE PATIENT ASSISTANCE PROGRAMS IN ADDITION. THEIR SEGMENTS OF THE POPULATION THAT ARE NOT ABLE TO PARTICIPATE IN VARIOUS INSULIN MANUFACTURE PROGRAMS. IN PARTICULAR URGENCY SITE.>>MISTER CHAIRMAN I MISTER CHAIRMAN REPRESENTATIVE POWER WITH THE DEVELOPMENT OF THIS PROGRAM ARE YOU INTENDING TO REPLACE THE PATIENT ASSISTANCE PROGRAMS THAT ARE CURRENTLY PROVIDED BY INSULIN MANUFACTURERS ARE YOU LOOKING TO SUPPLEMENT.>>MISTER CHAIR PERCENT DROP LOW; WE’RE LOOKING TO CREATE IT GUARANTEED SAFETY NET FOR MINNESOTANS THAT PATIENT ASSISTANCE PROGRAMS DO NOT OFFER THAT RIGHT NOW WE’RE NOT SAYING THEY SHOULDN’T EXIST AND WE ARE GLAD THAT THERE’S BEEN SOME CHANGES TO THEM BUT. EVERYTHING WE FOR FOR PATIENTS ARE THAT THEY’VE GOT A LONG WAY TO SO WITH THIS AND I WOULD MENTION ALL 3 OF DIFFERENT ELIGIBILITY STANDARDS THAT DO DIFFERENT THINGS DIFFERENT WAYS. THIS CREATES A UNIFORM ACCESSIBLE WAY FOR MINNESOTANS IN NEED TO ACCESS. EMERGENCY SPY VINCENT. SUPPLEMENT OR REPLACE. BUT MISTER CHIPS AND GOT WHAT ABOUT THAT WAS CLEAR FROM ANSWER BUT SUPPLEMENT I GUESS IF YOU WANT TO I WOULD GET THAT THE ISSUE IS WHAT THE CURRENT STATUS QUO ISN’T DOING IT. SO WE NEEDED A MINNESOTA INSULIN PROGRAM TO GUARANTEE THAT MINNESOTA NICE TO HAVE ACCESS.>>CHAIRMAN REPRESENT OUR PARENTS OR SUPPLEMENT AND WHY YOU OVERLAPPING WITH THE EXISTING PROGRAMS WHY NOT JUST SAY YOU’RE NOT. HERE’S YOUR POPULATION OF ARE NOT COVERED BY AND HAVE A PROGRAM ASSISTANT. IT’S MEANT TO SUPPLEMENT A FINAL LETTER.>>MISTER CHAIR PERCENT DROP FOR THAT IS A GOOD QUESTION. THE ONE OF THE CHALLENGES WITH THE PATIENT ASSISTANCE PROGRAMS ARE FRANKLY THAT THEIR CREDIBILITY WITH PATIENTS ARE SO LOW BASED ON THEIR PAST PERFORMANCE THEY MAY ON PAPER AROUND THEIR PRESS RELEASE WITH IS CERTAIN ELIGIBILITY PIECES AND THINGS ARE OR IF YOU MOVING IN THE RIGHT DIRECTION. BUT THE PATIENT EXPERIENCE WHAT WE’VE HEARD HASN’T IT PROVED SO WHAT WE’RE TRYING TO DO IS CREATE A STANDARD TO CREATE A SYSTEM THAT WE KNOW WORK FOR MINNESOTANS AND IF THOSE PATIENT ASSISTANCE PROGRAMS CONTINUE TO IMPROVE AND CONTINUE TO. EXPAND AND GET BETTER YOU KNOW THIS BILL COULD GO AWAY RIGHT. THE FOR EXAMPLE THE FEE AND MANUFACTURES IF PATIENTS. IF THE PATIENT ASSISTANCE PROGRAMS; THE DRUG MANUFACTURERS WORKED WELL PATIENTS KNEW ABOUT HIM THEY COULD UTILIZE AND THEY CAN GO TO THOSE PROGRAMS AND THIS FEE WILL COLLECT ANY MONEY. SO BUT THAT DOESN’T EXIST RIGHT NOW WHICH IS WHY WE NEED EMERGENCY INSULIN PROGRAM HERE IN MINNESOTA.>>CHAIRMAN REPRESENTATIVE OUR NOT TO SAY THAT IF LET COM BUT INSOFAR CREDIBILITY AND HEALTH CARE SERVICE DELIVERY; I’M NOT SURE TRUSTING MEN SURE IT’S REALLY THE WAY TO GO BASED OFF OF PREVIOUS TRACK ALSO STAYING ON SUBDIVISION 3 UNDER ELIGIBILITY REQUIREMENTS AND I CAN READ THE WHOLE THING BUT THERE’S A WORD HERE THAT TO BE ELIGIBLE FOR THE PROGRAM AN INDIVIDUAL MUST HAVE A VALID PRESCRIPTION THEY MUST FOR INSULIN AND THAT SAYS A TEST. THEY JUST HAVE TO ATTEST TO BEING A RESIDENT OF MINUTES TO THEY HAVE TO ATTEST NOT BEING INVOLVED IN MEDICAL ASSISTANCE OF MINNESOTA CARE. THESE OTHER CRITERIA AND SO MY QUESTION FOR YOU IS IN THE FISCAL THAT WE SEE WE’VE WE’VE HEARD YOU TALK ABOUT THE OUT OF COP OUT COSTS FOR INSULIN AS HIGH $100 A MONTH. THAT’S THE CASE ARE WE MAKING MINNESOTA JUST A HUGE WELFARE MAKE IT FOR FREE AND FLED FROM OTHER STATES. WHY WANT EVERYBODY TO COME HERE AND GET THAT’S BECAUSE YOU’RE NOT WRITTEN BY RING I ALL YOUR FIRINGS PRESCRIPTION IF YOU LIVE IN HUDSON WISCONSIN. WHY WON’T YOU COME OVER TO MINNESOTA AND GET YOUR FREE AND LIVE IN. FARGO WHY WOULD SHE COME TO MINNESOTA IF YOU LIVED IN SHIP GO WHY WOULD YOU MAKE A WEEKEND NOT AND WE’RE TALKING DOSAGES OF 1350 A MONTH. AREN’T YOU CONCERNED ABOUT THE ONCE AGAIN MINNESOTA’S OVERLY GENEROUS PUBLIC HEALTH PROGRAMS BEING ABUSED BY NON-STATE RESIDENT.>>MISTER CHAIR PERCENT DROP WE WELL ONE WE NEED TO MAKE SURE THAT THE PROGRAM IS TAILORED FOR MINNESOTANS AND THAT’S WHAT THIS PROGRAM DOES BUT JUST A COUPLE COMMENTS SPECIFIC TO YOUR QUESTION. ONE THING BY UTILIZING A 3RD PARTY ADMINISTRATOR TO ADMINISTER THIS PROGRAM WERE ABLE TO PREVENT SOMEBODY FROM BEING ABLE TO SAY GOING TO THIS CBS GET THEIR EMERGENCY REFILL AND THEN GO TO A DIFFERENT PHARMACY ACROSS THE STREET AND GET ANOTHER AND CALLING OUT THIS BILL IS FOR THE EMERGENCY SUPPLY YOU’RE ELIGIBLE FOR A ONE-TIME FILL IN A CALENDAR YEAR. IN TALKING WITH PHARMACISTS. IT WOULD CREATE QUITE THE CHALLENGE TO MOST PEOPLE ARE GOING GO TO THE PHARMACY WHERE THEIR PRESCRIPTION IS ON FILE THAT IS GOING TO BE WHERE THE LION SHARE YOU KNOW BARRING IT SOMETHING OUT OF THE ORDINARY FOR PEOPLE ACT; YES; THEIR MEDICATION SO YOU KNOW MOST PEOPLE IN CHICAGO ARE GOING TO HAVE THEIR THEIR VALID PRESCRIPTION ON FILE. YOU KNOW IT IN MINNESOTA PHARMACY AND SO. WE TAILOR THIS PROGRAM THE WAY TO MEET THE NEED TO MINNESOTA AND IN NEED.>>WITH REGARDS TO HAVING A PRESCRIPTION ON FILE AT A AT THE 2 MINUTE PHONE CALL THEIR DOCTOR. NOT REALLY AN ISSUE IN IS THERE ANY WOULD YOU BE WILLING TO AT LEAST MODIFY THE LANGUAGE OF THE PRESCRIPTION HAD BEEN WRITTEN IN MINNESOTA OR BUT SOME LEVEL OF RESIDENCY REQUIRE VERY AND RIGHT NOW THE VERIFY ING IS THAT THERE’S A VALID DESCRIPTION; BUT IT DOESN’T IT DOESN’T TAKE A ROCKET SCIENTIST TO FIGURE OUT THAT WE’VE GOT TO GET DIRECT TAXES RIGHT NOW THERE’S A VERY LUCRATIVE BOOTLEGGING OPERATION FOR CIGARETTES IN NORTH DAKOTA RIGHT NOW THANKS TO OUR HIGH. ARE EXCESSIVELY HIGH CIGARETTE TAXES UP HERE. DO YOU HAVE ANY CONCERNS ABOUT THAT BEING USED. THEY GET ALL YOUR IF LAYERING IS A I PROMISE I’M NOT ANY OF THESE THINGS AND HERE’S LANCELIN FIRST ARE YOU CONCERNED ABOUT OTHER STATE RESIDENTS. MISUSING OUR PROGRAM.>>MISTER CHAIR OF THE OUTFLOW GENERALLY I WOULD SAY IN MY. THE CONCEPT OF ABUSE WHEN WE’RE TALKING ABOUT INSULIN FOR TYPE ONE DIABETICS I JUST WANT TO CALL OUT THAT YOU KNOW THIS IS IT THAT MEDICATION THAT PEOPLE NEED TO LIVE. IT THIS ISN’T SOMETHING WHERE IT’S NOT BECAUSE YOU CAN GET ONE TIME IT’S NOT STRUCTURED IN SOME WAY WHERE SOMEBODY WITH A VALID. PRESCRIPTION COULD COME IN AND GET THIS HUGE STOCKPILE OF THE AND OUR PRIORITY IS TO MAKE SURE THAT IF YOU’RE IN THAT JUST DESPERATE SITUATION LIKE ALEC WAS THAT YOU HAVE PATH TO GETTING AFFORDABLE SUPPLY OF INSULIN.>>MISTER CHAIRMAN I’M THAT ROUTE SO I THINK THAT’S MY FINAL I I DO THINK THE AUTHOR AND I KNEW THIS BILL THEY’RE FROM WE BUT IF HE’S LOOKING TO HAVE A PROGRAM SIGNED INTO LAW I WOULD STRONGLY COURAGE YOU TO LOOK AT THAT WORD A TEST AND TO COME UP WITH SOMETHING BESIDES JUST HAVING A VALID INSULIN PRESCRIPTION; ESPECIALLY WHEN YOU FACTOR IN THE B OVERALL UMBRELLA ISSUES OF HIGH-DEDUCTIBLE PLANS THAT IS A SIGNIFICANT FINANCIAL INCENTIVE FOR TIME MINNESOTA RESIDENTS TO COME HERE AND USE THAT PROGRAM AND I JUST I WOULD CAUTION YOU TO BE AWARE THAT MISTER CHAIRMAN AND MEMBERS THIS IS OBVIOUSLY IT’S A COMPLICATED ISSUE. WE’VE HAD A LOT OF THINGS CHANGE IN THE LAST YEAR ON THIS ISSUE. YOU KNOW THE ADVOCATES FOR THIS WE’RE SUCCESSFUL IN GETTING IRS TO CHANGE THE TAX RULING AROUND THIS IS A PREVENTATIVE GO INTO MEDICINE AND SINK IN CREDIBLE ACCOMPLISHMENT. HERE IN THE STATE OF MINNESOTA SENATOR BENTSEN WHO JUST AN AMAZING THING LAST YEAR BY IT SLIPPING A PROVISION IN THE OMNIBUS BILL NOT A FAN OMNIBUS BILLS BUT WAS THIS CASE IT WORKED OUT WHERE SHE WOULD MAKE SURE THOSE INSULIN REBATES WERE PAID FOR BY INSULIN MANUFACTURERS. BUT THOSE ARE NOW FROM MINNESOTA REGULATED PLANS A 100% GOING TO THE PATIENTS THE INSURANCE COMPANIES CAN’T USE THAT TOO LOWER PREMIUMS OR SPEND IT ON OTHER MONEY. AND THEN 3RD FINALLY IS THE LARGE AND ROBUST EXPANSION OF THESE PATIENT ASSISTANCE PROGRAMS. BOTH FOR EMERGENCY INSULIN AS WELL FOR DISCOUNTED INSULIN THAT HAVE TAKEN PLACE THEY HAVE THE ADVOCATES AROUND THIS HAVE GOTTEN THE IRS TO TAKE ACTION THEY HAVE GOTTEN MINNESOTA LAW CHANGED AND THEY’VE BEEN SUCCESSFUL AND GETTING THE PHARMACEUTICAL INDUSTRY THEM UP. AND THAT’S A THAT’S A PRETTY SIGNIFICANT ACCOMPLISHMENT ANY ONE OF THOSE 3 THE FACT THAT ALL 3 OF HAPPENED. IS A PRETTY IT’S PRETTY INCREDIBLE. BUT I WOULD JUST SUBMIT TO MEMBERS TO BE AWARE AS WE WORK ON THIS ISSUE WE TOUCH IT THERE ARE UNINTENDED CONSEQUENCES WITH THE BEST OF INTENTIONS I’VE HIGHLIGHTED THE A TEST AND THE CREATION OF AN ENTITLEMENT. I JUST ALSO BE AWARE THAT THERE’S A PHARMACIST INVOLVED IN THIS. AND WHAT WE’RE ASKING OF THEM TO DO AND THE REIMBURSEMENT PROCEDURES AND THAT THE REQUIRED TO KEEP ON STOTT. WE’LL SEE WHAT HAPPENS WITH THE SENATE WILL SEE WHERE YOU GUYS TAKE THIS BUT I DO THINK THAT THIS IS A SERIOUS ISSUE AND IT MERITS MORE SERIOUS CONSIDERATION; I’M VOTING NO ON THIS BILL TODAY; I’M VOTING NO DOES NOT MEAN THAT I’M IN FAVOR OF PEOPLE DYING AS THE LEAD BY OTHERS DOES NOT MEAN THAT I’M SOME A SHILL FOR THE INSULIN MANUFACTURERS; I’M PROUD OF THE FACT THAT I VOTED FOR THE OPIOID BILL S HERE THAT WAS OPPOSED BY THE PHARMACEUTICAL INDUSTRY. BUT IN THIS CASE AND THIS CASE ONLY. THE PHARMACEUTICAL INDUSTRY IS GETTING A BAD RAT THEY’RE NOT GETTING THE MONEY. THIS IS THE REBATES ARE NOT THE REBATES ARE ARE BEING PAID FOR BY THE PHARMACEUTICAL INDUSTRY. THEY’RE NOT THEY’RE NOT GETTING THE MONEY. THE SUPPLY CHAIN AND THIS IS A NEW HEALTHCARE SUCH A SCREW-UP ISSUE EVERYTHING FROM TOP TO BOTTOM YOU CAN YOU’RE REPEAT NOT ONE SINGLE ISSUE ON IT BUT BE AWARE OF THE FACT THAT IN THIS CASE. THE PEOPLE MAKING THE INSULIN ARE NOT THE PROBLEM THAT’S NOT WHERE THE MONEY IS GOING AND WE HAVE EXHAUSTED AMOUNTS OF DATA THAT THEY’RE LOOKING TO WHETHER IT’S 50 OR 70%. BUT A SIGNIFICANT PORTION OF THE MONEY THAT’S BEING PAID BY INSULIN CUSTOMERS IS NOT GOING TO THE MANUFACTURERS AND I DON’T THINK IT’S RIGHT TO PUNISH THEM WHEN THE 9 ONE IS GOING TO BE VOTING NO. THANK YOU MISTER CHAIRMAN REPRESENT OVER. I THINK MISTER CHAIR JUST A QUICK QUESTION FOR PERCENT OF POWER IS THERE.>>ANYTHING THAT WOULD STOP A PHARMACEUTICAL MANUFACTURER TERMINATING THE PATIENT ASSISTANCE PROGRAMS TOMORROW. MISTER CHAIR OF LONG BACKED EACH OF THE PROGRAMS ACTUALLY EXPRESSLY. CALL OUT THAT THEY COULD CANCEL OR REBOOK THOSE PROGRAMS ANY TIME. THAT PERCENT LEGALLY.>>THANK YOU MISTER CHAIR JUST WANT AT A FEW THINGS RESPOND A LITTLE BIT TO REPRESENT A CORRUPT WELL FIRST OF ALL ON THE ISSUE ENSURE LIKE THIS. YOU ENSURE THE GREAT EVIL THING. THE REASON MEN SURE IS IN THIS BILL IS AND I WAS PART OF THE WORK GROUP THAT NEGOTIATED WITH THE SENATE OVER A LONG PERIOD OF TIME THAT WAS THE DESIRE OF THE SENATE REPUBLICANS I WANT YOU TO UNDERSTAND THAT VENTURE HAS BEEN DOING SO SO WELL; AND IS NOW IS RUNNING THINGS SO SMOOTHLY THAT THEY WANTED MEN SURE TO DO THIS NOW ENSURES BEING ASKED TO DO HERE IS REPRESENTING HOWARD SAID IS PRETTY LIMITED. BUT THAT WAS THAT WAS NOT COMING FROM US. THAT CAME FROM THEM I JUST WANT YOU TO UNDERSTAND THAT THE ISSUE ABOUT A TESTING. YOU AS REPRESENT OF HOWARD SAID YOU HAVE TO REMEMBER THAT THIS IS A DRUG THAT IF YOU DON’T GET IT WHEN YOU NEED IT. YOU BECOME VERY ILL VERY QUICKLY YOU RACK UP TREMENDOUS COST AND YOU CAN DIE. AND WE’VE SEEN THAT THIS HAS HAPPENED SO EVERYTHING IS A BALANCE WHEN YOU SET UP A PROGRAM; IT’S A BALANCE BETWEEN HOW MUCH PROGRAM INTEGRITY ARE WE GOING TO DO IF YOU WILL VERSUS HOW LONG DOES THAT TAKE AND WHAT TROOPS TO PEOPLE HAVE TO JUMP THROUGH AND SO THERE’S BEEN A LOT OF CONSIDERATION OF HOW CAN WE STRIKE THE BEST BALANCE HERE. AND YOU KNOW NO PROGRAM NO NEW PROGRAM IS PERFECT OUT OF THE BOX I WOULD BE SHOCKED IF THIS DIDN’T HAVE TO BE IN SOME WAY ADJUSTED GOING FORWARD IN FUTURE YEARS. BUT THE IDEA OF A TESTING IS BECAUSE AND AND THIS PART I HAVE TO TELL YOU THE SENATE REPUBLICANS ALSO AGREED TO BUT A TESTING IS THE WAY TO GO BECAUSE OTHERWISE THE PROCESS IS TOO LONG WHEN SOMEBODY LIKE ALEX SMITH SHOWS UP AT THE PHARMACY AND DOESN’T HAVE THE MONEY TO GET HIS INSULIN. IT IS A TRUE EMERGENCY AND SO WE WOULD RATHER ERR ON THE SIDE OF SOMEBODY GETTING SOME THING THAT MAYBE THEY SHOULDN’T REALLY BE ENTITLED TO BECAUSE THAT THE OF THE THING WE RISK IF WE DON’T GIVE THAT TO THEM IS THAT THEY WILL LITERALLY DIE SO THAT IS THE CALCULATION THAT’S BEING MADE HERE NOTWITHSTANDING I I HEAR YOUR CONCERNS. I DON’T KNOW MAYBE PUTTING IN A WORD THAT HE HAS TO BE I DON’T KNOW WE COULD MAYBE THINK ABOUT I DON’T KNOW OF REPRESENT OF HOWARD TO BE WILLING. BUT THE ISSUE ABOUT MINNESOTA RESIDENCY. I DON’T KNOW MAYBE THAT COULD BE HANDLED SIMPLY; BUT ANYWAY THE THE FINAL I WANTED TO SAY IS I LOVE HOW SOME OF THE REPUBLICAN MEMBERS IS JUST ARRIVING ON THE BEN SOME PROVISION THAT IS BEING CREDITED WITH BRINGING DOWN OUT OF POCKETS ON INSULIN. WELL WE HAVE AN ANSWER FOR YOU IF YOU LOVE THAT AND IF IT REALLY WORKED WE’VE GOT A BILL TO DO THAT FOR ALL THE DRUGS. SO IT SHOULD WORK BEAUTIFULLY FOR ALL OF TO WORK FOR THE INSULIN AND SO YOU PROBABLY WILL BE SEEING THAT THIS YEAR IS GREAT; YOU KNOW I MEAN IF THAT WAS REALLY THE CAUSE AND I HAVE TO TELL YOU THAT’S GREATLY DISPUTED BY A NUMBER OF DIFFERENT PEOPLE WEATHER. SENATOR BEN SAYS PROVISION WAS RISKY A COUPLE FOR THAT; BUT IF IT WAS THEN LET’S DO IT FOR OTHER DRUGS TO BECAUSE PATIENTS ARE SURE HAVING A HARD TIME PAYING FOR THEIR PHARMACEUTICALS EVEN WHEN THEY HAVE INSURANCE.>>YOU’RE THE ONE THAT WAS CONCERNED ABOUT MIDNIGHT; THANK YOU MISTER CHAIRMAN AND THANK YOU.>>MY COLLEAGUE REPRESENTATIVE I DO THINK IT’S IMPORTANT TO POINT OUT THAT WHAT’S HAPPENED HIM IN SO THAT WITH THE MINNESOTA REGULATED PLANS THE $0 COPAYS THE $25 IN A PHASE. THAT IT HAPPENED IN ANY OTHER STATE. EVEN IN COLORADO WHERE THEY PUT A CAP A HARD CAP AND IT’S LIKE OH PAYS AND SO WHAT HAS HAPPENED IS REPRESENTATIVE BENSON AND I I UNDERSTAND SOME OF THE SELLERS ARE UPSET ABOUT THIS. BUT REPRESENTATIVE BENSON KIND OF TRICKED THE DFL INTO MAKING HER POINT. THE POINT WAS THE INSULIN MANUFACTURERS ARE NOT THE ONES GETTING THE MONEY THE MONEY WAS GOING TO THE HEALTH ONCE THEY WERE USING THEY WERE MAKING MONEY OFF OF INSULIN AND USING IT TO LOWER PREMIUMS AND PAY FOR OTHER COSTS.>>AND IT TO ME IT SEEMS AND I UNDERSTAND IT’S NOT THE NARRATIVE THAT’S NOT WHAT PEOPLE THAT PEOPLE WANT TO.>>WHITE FIGURES THE INSULIN MANUFACTURERS; BUT THE RESULTS WERE PRETTY I MEAN IT’S IT’S PRETTY INCREDIBLE WHAT’S HAPPENING. MINNESOTA IN THE LAST 6 MONTHS WITH THAT ONE CHANGE AND WITH REGARDS TO YOUR OTHER ISSUE REGARDING HAVING THAT APPLY TO ALL MEDICINES. I WOULD BE A 100% IN FAVOR OF THAT GOOD WHY WOULD WE WHY WOULD WE TAKE THE REBATES THE MEDICINE PRODUCERS ARE GIVING. WHY WOULD WE WANT THAT MONEY TO GO ANYWHERE ELSE AND TO THE CONSUMERS WERE PUT PURCHASING THE MEDICINE. THE FIRES LOGIC IT DOESN’T MAKE ANY SENSE BUT WHAT MY WHAT I WILL LET THEM WHEN A DISPUTE IS THAT SOMEHOW SENATOR BENSON’S PROVISION WAS JUST UNRELATED FACTOR KNOW THAT’S THAT’S WHAT HAPPENED. IT WAS ONE THAT 10 SMARTEST THINGS I’VE SEEN IN MY 16 YEARS THE LEGISLATURE AND SENATOR BENTSEN INSTEAD OF BEING DEMONIZED SHOULD BE CREDITED FOR BEING LOOKED BRINGING LOW COST INSULIN TO THOUSANDS OF MINNESOTANS EVEN TESTIFY ERS REPRESENTATIVE HOWARD HAS INVITED BEFORE COMMITTEES HAVE PUT STACKS OF ONE IN THE TABLE TALKING ABOUT HOW MUCH IT COST AND SAID WELL. BUT YEAH WE GET OUR INSULIN CHIEF NOW BECAUSE OF THE VENTURE PLANT OH I DON’T THINK SHE’S GETTING THE CREDIT. HE DESERVES FOR IT AND IT IS A HUGE CHANGE. ANY FURTHER DISCUSSION OF THE PEOPLE IN THAT YOU CARRY WITH YOU MORE.>>YES MISTER CHAIR I WILL RENEW MY MOTION AND JUST SAY THAT NOBODY YOU KNOW IF IF INDEED; THIS IS A THIS IS SOMETHING IS BECAUSE OF SOMETHING THAT SHE DID GREAT IT’S GREAT. LET’S DO IT FOR ALL THE DRUGS AND YOU KNOW; AND I’M GLAD WE WILL HAVE YOUR THAT SO WITH THAT I RENEW MY MOTION THAT HOUSE FILE 3100 A READER FOR IT TOO. THEN THE 3RD IN GROSS MEANT THE RECOMMENDED TO BE PLACED ON THE GENERAL REGISTER. IN THE MOTION IS BEFORE US ANY FURTHER DISCUSSIONS.>>SCENE AND THEN ALL THEIR SIGNIFY BY