HUNTINGTON — As a single mother, small-business owner and a diabetic, Tia Fix Rumbaugh is thankful for her West Virginia Medicaid coverage because she knows what it is like to be without it.
After leaving West Virginia for Alaska, she moved back to Huntington and had a four-month waiting period before Medicaid kicked back in. She spent $500 a month out of pocket on her diabetes supplies. She had to open credit cards and rationed her insulin to get by. Today she plays the balancing act of ensuring she doesn’t make too much money so she remains eligible for Medicaid.
Rumbaugh was unable to join a group of West Virginians who traveled to Canada this past weekend to purchase insulin, but she would have welcomed the chance to purchase a three-month supply of the life-sustaining drug.
Jeanette Rowsey, a Democratic candidate for the state House of Delegates District 17, did take the trip, however. Though not a diabetic, Rowsey said she wanted to learn more about an issue affecting thousands of West Virginians. She said on average, people who traveled to Canada as part of the caravan saved 60% on their medication.
Roughly 15% of West Virginians suffer from diabetes and depend on insulin to keep them alive, according to the state Department of Health and Human Resources. In the past decade, insulin prices nationally have been rising, making it more difficult for some to access the medication, no matter their health insurance status.
According to the Health Care Cost Institute, an individual with Type 1 diabetes paid an average of about $6,000 in 2016 for insulin. Since then, prices have only gone up. Numerous stories of individuals across the nation rationing their insulin due to the high costs have made headlines in the past year. Some have died.
Kim Jones’ daughter was diagnosed with Type 1 diabetes when she was 7. In 2011, a month supply of NovoLog, a fast-acting insulin, cost $619. By 2017, the same supply cost $1,473.
Jones said they were blessed to have the Children’s Health Insurance Program, or CHIP, the federal program that provides low-cost insurance to children whose families make too much to qualify for Medicaid. However, her daughter has aged out of CHIP and is now on Jones’ state Public Employees Insurance Agency (PEIA) plan.
“I woke up crying the day she joined PEIA,” Jones said.
In eight months, her daughter has already racked up $3,000 in medical debt just to pay for her everyday maintenance of her condition. Neither Jones nor her daughter were able to attend the Canada trip.
The Canada trip was organized by Dels. Barbara Fleischauer, D-Monongalia, and Jordan Hill, R-Nicholas. The two delegates are working on a bipartisan bill that would cap the amount a covered person is required to pay for covered prescription insulin at $25 for a 30-day supply. A draft of the bill was included in a packet of legislation given to members of the Joint Health Committee during the November interim meeting. The legislation will be considered during the upcoming session, which begins Jan. 7.