Minnesota’s insulin safety net is a critical resource, especially as the new year begins

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When my son Alec passed away after rationing his insulin, my world shattered.

Alec, like many people with diabetes, found himself stuck in a cycle of soaring insulin prices. With insurance, he was paying hundreds of dollars monthly for insulin. Without insurance, the cost of that monthly supply jumped to $1,300. The sky-high price forced Alec to stretch out his doses, and less than a week later, he died from diabetic ketoacidosis.

Tragically, Alec wasn’t alone. As I shared his story with local news stations and reached out through social media, I was flooded with responses from others in similar situations — people rationing insulin, resorting to desperate measures to survive. I learned of individuals traveling to Canada or Mexico to buy insulin more affordably or meeting strangers in back alleys to exchange lifesaving supplies. It was a heartbreaking realization: Alec’s death was part of a much larger crisis.

When state Sen. Erin Murphy, herself a nurse, heard Alec’s story, she reached out. She wanted to help, and together we discussed the importance of an emergency insulin affordability program that could prevent future deaths due to rationing. In testimony before Minnesota’s Health and Human Services Committee, I shared Alec’s story, and the support was overwhelming. Sen. Michael Howard also stepped forward, motivated to make a difference as he ran for office. Working alongside Gov. Tim Walz, they championed what would become the Alec Smith Insulin Affordability Act, turning a vision into reality.

The legislation established the Minnesota Insulin Safety Net Program, which has since provided relief to countless Minnesotans. The program allows individuals in need of insulin to access a 30-day emergency supply through their pharmacy and, more importantly, gives them a path to longer-term assistance. The continuing-need branch of the program allows eligible Minnesotans who cannot afford their insulin on an ongoing basis to receive a 90-day supply for no more than $50.

As we approach the new year, the need for this program is particularly high. Individuals with high-deductible health insurance plans may face hundreds of dollars in out-of-pocket costs for their prescribed insulin in the first several months of the year. The Insulin Safety Net Program can be a lifeline, helping them afford insulin before they meet their deductible.

Additionally, many Minnesotans are traveling to see loved ones during the holidays and battling extreme weather, creating more possibilities for a vial to be left at home, spoil in excessive cold or shatter while on the go. The urgent-need program offers a life-saving option in potential emergency situations.

We’ve made significant strides in Minnesota, but no one should have to cross state lines or choose between survival and financial ruin for a medication they depend on daily. Access to insulin should never be a privilege — it must be a guarantee. We need to honor the life Alec lived and ensure the pain of our loss drives meaningful, lasting change for everyone who relies on insulin.

Minnesotans have access to an innovative solution, and it’s up to all of us to ensure the program reaches those who need it most. This holiday season, take a moment to share this vital resource with friends, family and neighbors. Ask if they are familiar with the Insulin Safety Net Program and encourage them to spread the word. Every conversation has the potential to create change and, ultimately, save a life. Together, we can make access to insulin a reality for all.

Nicole Smith-Holt lives in the Minneapolis area and is a mother of four. She became a policy advocate for insulin access and affordability after the death of her son Alec in 2017. She serves as a co-chair of the Minnesota Advisory Task Force on Lowering Pharmaceutical Drug Prices and is part of the Founder’s Council for United States of Care.