As Minnesota lawmakers rush to reach a deal on a state budget before the session ends on Monday, advocates for many issues worry that their causes will get lost in the mix.
From diabetics and medical marijuana patients to opioid abuse victims and elder care advocates, the most uncertain stretch of the legislative session is here. And many of them are mounting a final push to get their priorities through.
Some of their issues will hinge on a budget agreement between Gov. Tim Walz and legislative leaders. Over the past several days, the state’s leaders have quarreled behind closed doors over the future of state spending, the gas tax and an expiring tax on health care providers.
If they do not reach an agreement in the next couple days, these issues may be pushed into a special session, or even delayed until next year.
Here’s a look at some of the issues that are still in play.
EMERGENCY INSULIN FOR DIABETICS
A group of Minnesota diabetics has made several appearances at the Capitol this year, sharing stories of loved ones who could not afford their insulin and lost their lives because of it. The average price of insulin has nearly tripled in the past decade.
During a Monday news conference, they urged lawmakers to unite behind a proposal that would give diabetics an emergency supply of insulin if they cannot afford it.
“If I go even a couple of hours without insulin, I run the risk of diabetic ketoacidosis,” said Abigail Hansmeyer, a Type 1 diabetic from New Brighton. A vial of insulin cost her $20 when she was diagnosed with diabetes in 1996, she said. Now, that vial costs her $240 — and she needs two to three of them per month.
The emergency insulin act is wrapped into the House and Senate health and human services budget bills, but the versions are slightly different.
Those who have high-deductible insurance plans could get an emergency refill under the House bill, but not the Senate plan. And the House bill would provide an emergency supply of 90 days, as opposed to the Senate proposal of 30 days.
Lawmakers will have to compromise on these sticking points. But even if they do, the fate of the emergency insulin provision may hinge on budget negotiations. The lawmakers behind the bill have said they may push it as a standalone policy if the budget stalemate continues.
AILING PATIENTS SEEK CHEAPER MEDICAL MARIJUANA
Lawmakers are also weighing fixes to Minnesota’s troubled medical marijuana program, which is widely seen as one of the most restrictive in the country.
New patients have left the program in droves, turning to the black market or prescription opioids because they cannot afford the processed pills and oils that are legal. The costly marijuana offerings are not insured and only patients with one of 13 severe conditions can use them.
Proposals to let the state’s two manufacturers double their dispensaries, write off their business expenses and buy hemp from local farmers have garnered bipartisan support in final negotiations.
A measure that would legalize the marijuana plant for medicinal use will likely be voted on this week. It is more controversial and does not have a clear path. But many patients have said they would prefer to use the real plant and the state’s two manufacturers admit it would be cheaper to sell.
“This is the easiest and quickest way to (increase affordability and accessibility) this session,” said Maren Schroeder, co-founder of Sensible Change Minnesota, a group that wants to expand access for the more than 15,000 medical marijuana patients in the state.
ADDRESSING THE OPIOID EPIDEMIC
A bipartisan proposal to levy a new fee on opioid manufacturers and distributors has been stuck in negotiations for a month.
The fees would raise $20 million a year for addiction prevention and treatment to help address the state’s growing opioid crisis. The powerful painkillers are linked to the deaths of more than 400 Minnesotans in 2017 and four out of five heroin addictions start with people abusing prescription drugs.
Shelly Elkington’s daughter Casey got hooked on opioids as she coped with Crohn’s disease. She died as a result of her addiction in August of 2015.
“The minute we can make our loss sting a little bit less by bringing solutions to families, it’s good,” said Elkington, a Montevideo resident who has pushed for action at the state Capitol.
The finish line for the bill is in sight, but lawmakers first need to settle disagreements over whether the fee should end if the state receives money from a lawsuit with opioid makers and distributors.
Senate Republicans want the fees to sunset if the state receives $20 million in settlements. House Democrats initially opposed the expiration but sent a counteroffer last week that would let the fees expire after $700 million in settlements.
PROTECTIONS FOR THE ELDERLY
Advocacy groups and lawmakers are also pushing to protect Minnesota seniors from abuse and neglect in assisted living facilities and nursing homes.
There are several legislative proposals on the table, including:
- Licensure of assisted living facilities; Minnesota is the only state in the nation that does not license them.
- The ability for residents to have cameras in their rooms.
- New guidelines that protect residents and their families against retaliation.
- A prohibition on deceptive marketing practices related to the services a facility provides.
The package of reforms already passed in the House. In the Senate, the proposals await a hearing before they can get to the floor.
“We’re waiting for (budget) targets. All of this hinges upon getting targets so we know what we have to spend,” said state Sen. Karin Housley, R-St. Marys Point, who is carrying many of these reforms.
She remains optimistic that the reforms will pass in the session’s final days, whether they move in their own bill or are included in the larger health and human services package.