Nicole Smith-Holt reacted from the gallery during the insulin affordability vote in the Minnesota House on Tuesday. (David Banks — Star Tribune/The Minnesota Star Tribune)

Tuesday's passage of a pioneering emergency insulin assistance bill is more than just good news for those Minnesotans who need this lifesaving medication. The measure's success also shows that people working together can overcome complex medical challenges, providing a welcome shot of confidence in the midst of the COVID-19 pandemic.

When Gov. Tim Walz signed the insulin bill on Wednesday, it was the culmination of well over a year of hard work at the Capitol. Rep. Mike Howard, DFL-Richfield, and Sen. Scott Jensen, R-Chaska, provided vital leadership, but the credit for this becoming a reality lies with the state's passionate insulin advocates and in particular, a grieving Minnesota mom.

In 2017, Nicole Smith-Holt's son Alec, who had diabetes, died after aging off her insurance plan and rationing his insulin. Smith-Holt channeled her sorrow into ferocious political advocacy, leading "die-ins" outside drugmakers' headquarters to protest high insulin prices and organizing caravans to Canada to buy the drug more cheaply there.

While many lament how long it took to get this measure passed in Minnesota, its progress has been relatively swift thanks to Smith-Holt and her fellow advocates. The state's innovative opioids bill, which levied a fee on drugmakers to offset treatment costs for this addictive class of drugs, took three years to pass, reflecting the lobbying might of the pharmaceutical industry.

Insulin advocates had to square off against this powerful special interest, too. Yet the assistance bill they sought almost became a reality in just one legislative session, becoming a casualty of last-minute maneuvering in 2019.

The subsequent outcry led to calls for a special session late last year and although that didn't happen, work on the issue continued, generating enough momentum for the measure to pass in 2020. Even so, advocates worried until the Senate vote on Tuesday that something would derail it.

The bill, HF 3100, involved some compromises to pass the DFL-controlled House and the Republican-controlled Senate. But it is nevertheless a substantial achievement, one that could well be a model elsewhere as alarm continues over insulin affordability.

"Insulin prices have increased by more than 50% since 2014," according to the GoodRx website. "With popular insulins like Humalog and Lantus costing north of $300 per vial, sick Americans who can't afford their insulin (regardless of whether they have health insurance or not) are resorting to risky 'quick fixes' like rationing doses or crowdfunding their next prescription fill."

Minnesota's bill appears to be the first of its kind in the nation. It will go into effect quickly. Beginning in July, Minnesota residents who are in urgent need of insulin and meet the program's reasonable guidelines can walk into a pharmacy and quickly get a 30-day supply for $35.

Medicare enrollees can also participate if they meet program guidelines specific to them. Their inclusion is something that advocates pushed for.

The Minnesota bill also gracefully solved a sticking point in negotiations. Advocates wanted pharmaceutical companies to directly fund the program, with some legislators proposing using the state's provider tax dollars instead. The measure now has firms supplying the program with insulin, and companies are subject to substantial fees if they do not participate. Relatively small sums of dollars from the provider tax pot of money will fund outreach and implementation.

On Wednesday, Smith-Holt watched online as Walz signed the bill that carries her son's name. She's not resting on this accomplishment. Next up: She's pursuing federal insulin affordability legislation. That's an even tougher battle, but we wouldn't bet against this determined Minnesota mom.