Diabetes Is Deadly, Costly For West Virginians. Lawmakers Hope To Change That.
West Virginia has the highest rate of deaths caused by diabetes, but proposed state legislation hopes to curb that.
Mindy Salango is a mom living in Morgantown and an advocate with the national group Protect Our Care. She said diabetes dictates everything she does in a day.
“It just really kind of ate at me the other day that my body is never going to function properly, and that I always have to fight and stay on top of it to stay alive,” Salango said.
To keep her blood sugar in check, Salango wears a device that checks her levels every ten minutes. She counts her carbs and injects insulin seven or eight times a day. She does this to prevent suddenly fainting at her steering wheel or having her daughter have to call the ambulance.
“She has had to watch me pass out from low blood sugar more times than I care to have had her see that. And she's had to, call emergency services to get them to help me because she couldn't wake me up,” Salango said.
Diabetes is the most expensive chronic health condition, according to the Centers for Disease Control and Prevention. However, not all insurance plans are equal, and the financial costs of the disease can be too much to bear. Salango remembers having to ration her insulin, a risky thing to do.
“I would have to not take as much, not eat as much, not eat as often, so that I could pay the bills, have food on the table for my daughter, keep our mortgage paid,” Salango said.
This is common; one in four diabetics say they have rationed their insulin in the past two years, according to the American Diabetes Association.
“People with diagnosed diabetes have medical costs that are nearly two and a half times that of people who don't have diabetes,” said Gary Dougherty, the association’s director of state government affairs
The ADA says a diabetic spends on average $9,000 a year treating their disease. The cost of insulin is three times higher than it was 20 years ago. Dougherty says a single vial of insulin can cost around $300.
“You can quickly see how the more vials of insulin somebody uses, how that cost can climb very quickly and sometimes into thousands of dollars,” Dougherty said.
About 16 percent of West Virginia adults have diabetes and are subject to these costs. State lawmakers have taken notice and acted. In 2020, the state legislature created a law that capped the amount a person could pay for insulin at $100 a month.
Del. Barabara Evans Fleischauer, D- Monongalia, brought forward that first step. She looked at other states’ laws and even traveled to Canada in 2019 with a group of diabetics to purchase much cheaper medications.
“We decided to go to Canada, to demonstrate that it didn't have to be the way it is in the United States,” Fleischauer said. “Some of the people saved hundreds of dollars that day. And that was sort of to let people know that we could do things differently in West Virginia.”
But Fleischauer says there’s more to do. This year’s House Bill 4252 passed overwhelmingly in the lower chamber. The bill now sits in the Senate’s health committee. It would drop the price of insulin from $100 a month to $35 dollars a month. It would also reduce the cost of devices diabetics use.
“[The bill] says that you can have an insulin pump every two years for $250. Those pumps, if you had to buy one off the market, are $5,000 to $7,000. And they literally will extend your life by a decade or two,” Fleischauer said.
Access to an insulin pump and other technology makes it easier for diabetics to control their illness, and that keeps people healthier and living longer. A West Virginian is more likely to die of diabetes than someone living in any other state, at about 1000 deaths a year.
A Cabell County doctor and the bill’s sponsor, Del. Matthew Rohrbach, R-Cabell, has seen patients wind up in some of the worst circumstances.
“Heart attacks, strokes, peripheral vascular disease, amputations, the need for prosthetics because of the amputations, those are all lessened if people will keep their diabetes under control. So this bill is an attempt to at least financially help them do that,” Rohrbach said.
If this bill passes, insurance companies will take on the extra costs, but Rohrbach says preventative care is essential to avoiding catastrophic outcomes, both physically and financially.
"I think the insurers can see the value in helping people be compliant. And in the long run, does it cost them a little bit more each month? Yes, but does it save a whole lot more each month? Yes. So it really is back to the ‘you can pay me now, or pay me later’ situation," Rohrbach said.
Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.