Ashley Hinson, Liz Mathis tangle over cap on out-of-pocket insulin costs

CEDAR RAPIDS — Capping the out-of-pocket cost of insulin is the latest flashpoint in the race for a northeast Iowa congressional seat.

The U.S. House has passed a bill capping the monthly cost of insulin at $35 for insured patients, part of an election-year push by Democrats for price curbs on prescription drugs during a time of rising inflation.

Public opinion polls have consistently shown support across party lines for congressional action to limit drug costs. However, two of Iowa’s three Republican representatives voted against the Affordable Insulin Act Now, arguing it could raise insurance premiums and make fewer drugs available in the future.

“Ensuring Iowans can afford their insulin is a top priority for me, for you,” Rep. Ashley Hinson said.

Nearly a quarter million Iowans, more than 10 percent of the state’s population, have diabetes, according to the American Diabetes Association. It estimates the total direct medical expenses for Iowans was $2 billion in 2017, with about $650 million more spent on indirect costs.

Rather than tackle the issue in a bipartisan way, however, Hinson said in a social media post Thursday, it was “so disheartening that Speaker Pelosi is moving forward with legislation that will actually raise premiums for over 200 million Americans.”

Her vote brought a rebuke from her Democratic challenger, state Sen. Liz Mathis of Hiawatha, who said Hinson has been “falsely telling voters she favors doing the opposite.”

“She’d rather protect the profits of her pharma donors than deliver on her promises to Iowans … instead of honoring her word and Iowans’ wishes,” Mathis said.

Hinson defended her vote, saying the Democratic plan would raise premiums for more than 200 million Americans. Capping cost sharing alone won’t lower the cost of insulin because insurers will pass along the cost.

“It also sets a very dangerous precedent that the government should be able to control the price of medications that Americans need,” she said. “So this is the wrong direction.”

The right direction, according to the Marion Republican, would be to pass the Lower Costs, More Cures Act that would cap out-of-pocket insulin costs at $50 a month and allows high-deductible health insurance plans to cover insulin costs before the deductible kicks in.

“We have to be working together to lower the cost of insulin and health care for everyone,” Hinson said. “This shouldn't be about playing politics with people's health, but the Democrats in Congress have made it that way.”

Hinson’s votes against capping insulin costs, Mathis said, is another case of saying one thing in Iowa, “but when she is in Washington, she votes against what Iowans need.”

Mathis pointed to an op-ed Hinson wrote in the Waterloo-Cedar Falls Courier saying she supported a “first-ever, out-of-pocket cap on insulin.”

In that opinion piece, Hinson argued for passage of the Lower Costs, More Cures Act because “Iowans deserve accessible health care they can depend upon and afford — folks shouldn’t have to choose between buying their groceries and medications they need.”

The idea of a $35 monthly cost cap for insulin has a bipartisan pedigree. The Trump administration had created a voluntary option for Medicare enrollees to get insulin for $35, and the Biden administration continued it.

But experts say the House bill would not help uninsured people, who face the highest out-of-pocket costs for insulin. Also, they say steep list prices don’t reflect the rates insurance companies negotiate with manufacturers.

The Hinson-Mathis race is considered “likely Republican” by the Cook Political Report, Inside Elections and Sabato’s Crystal Ball.

Comments: (319) 398-8375; james.lynch@thegazette.com

The Associated Press contributed to this story.