Impact of State Insulin Co-Pay Cap Bills

	A	B	C	D	E	F	G	H	I	J	K	L	M	N	O	P	Q	R	S	T	U	V	W	X	Y
1	Updated 2/20/2020							Maintained by @lollydaggle
2								Full write-up here (click for link)
3								Full write-up Part 2 here (click for link)
4
5		WHO WILL BE IMPACTED IF A STATE IMPLEMENTS A CO-PAY CAP ON INSULIN																						U.S. Rate of Insulin Dependence (6)	Percentage of people with diabetes using insulin (7)
6																								2.14%	27.00%
7						Analysis of Impacted Plan Types (1)																		Number of People with Diabetes Impacted
8		State		People with Diabetes (4)		Employer Small/Large Group (2)		Marketplace		Plans Impacted		Employer Self-Funded (2)		Medicaid		Medicare		TRICARE/ VA		Uninsured		Plans Not Impacted		Methodology 1	Methodology 2
9			State Population (3)	#	%	#	%	#	%	#	%	#	%	#	%	#	%	#	%	#	%	#	%	#	#

10		Alabama	4,741,500	568,980	12.00%	919,851	19.40%	292,076	6.16%	1,211,927	25.56%	1,259,817	26.57%	977,697	20.62%	745,838	15.73%	92,933	1.96%	452,813	9.55%	3,076,285	74.43%	25,930	39,266
11		Alaska	710,000	55,380	7.80%	135,326	19.06%	22,933	3.23%	158,259	22.29%	185,381	26.11%	156,413	22.03%	63,119	8.89%	48,209	6.79%	98,690	13.90%	453,122	77.72%	3,386	3,333
12		Arizona	6,841,200	622,549	9.10%	1,297,776	18.97%	396,105	5.79%	1,693,881	24.76%	1,777,344	25.98%	1,526,272	22.31%	1,046,704	15.30%	110,143	1.61%	686,172	10.03%	4,460,462	75.23%	36,242	41,619
13		Arkansas	2,909,900	325,909	11.20%	510,105	17.53%	183,324	6.30%	693,429	23.83%	698,667	24.01%	784,509	26.96%	450,744	15.49%	49,759	1.71%	233,083	8.01%	1,983,679	76.18%	14,836	20,969
14		California	38,713,800	3,716,525	9.60%	7,704,046	19.90%	2,876,435	7.43%	10,580,482	27.33%	10,549,511	27.25%	10,239,800	26.45%	4,181,090	10.80%	363,910	0.94%	2,799,008	7.23%	25,334,311	72.67%	226,378	274,246
15		Colorado	5,461,100	349,510	6.40%	1,169,768	21.42%	409,583	7.50%	1,579,350	28.92%	1,602,287	29.34%	1,073,652	19.66%	664,616	12.17%	131,613	2.41%	409,583	7.50%	3,472,167	71.08%	33,791	27,291
16		Connecticut	3,478,700	281,775	8.10%	790,013	22.71%	206,635	5.94%	996,648	28.65%	1,081,876	31.10%	706,176	20.30%	474,147	13.63%	23,655	0.68%	196,547	5.65%	2,285,854	71.36%	21,324	21,797
17		Delaware	931,800	92,248	9.90%	208,723	22.40%	48,454	5.20%	257,177	27.60%	285,783	30.67%	166,885	17.91%	155,611	16.70%	14,257	1.53%	51,994	5.58%	622,536	72.39%	5,502	6,874
18		DC	657,600	61,157	9.30%	147,565	22.44%	40,508	6.16%	188,074	28.60%	202,146	30.74%	184,523	28.06%	51,096	7.77%	7,891	1.20%	23,871	3.63%	445,656	71.40%	4,024	4,723
19		Florida	20,532,300	1,909,504	9.30%	3,441,213	16.76%	1,985,473	9.67%	5,426,687	26.43%	4,714,216	22.96%	3,819,008	18.60%	3,535,662	17.22%	381,901	1.86%	2,652,773	12.92%	12,450,787	73.56%	116,108	136,264
20		Georgia	10,121,400	1,082,990	10.70%	2,076,911	20.52%	657,891	6.50%	2,734,802	27.02%	2,845,126	28.11%	1,759,099	17.38%	1,194,325	11.80%	232,792	2.30%	1,354,243	13.38%	6,031,342	72.97%	58,513	79,008
21		Hawaii	1,356,100	105,776	7.80%	309,733	22.84%	65,364	4.82%	375,097	27.66%	424,324	31.29%	237,724	17.53%	199,347	14.70%	68,347	5.04%	51,261	3.78%	929,742	72.34%	8,025	7,900
22		Idaho	1,682,100	122,793	7.30%	330,196	19.63%	160,304	9.53%	490,500	29.16%	452,317	26.89%	293,526	17.45%	235,326	13.99%	29,941	1.78%	180,489	10.73%	1,011,110	70.84%	10,495	9,668
23		Illinois	12,496,600	1,137,191	9.10%	2,816,734	22.54%	751,046	6.01%	3,567,779	28.55%	3,857,700	30.87%	2,500,570	20.01%	1,637,055	13.10%	76,229	0.61%	856,017	6.85%	8,071,554	71.44%	76,335	87,660
24		Indiana	6,459,400	678,237	10.50%	1,443,030	22.34%	349,454	5.41%	1,792,484	27.75%	1,976,576	30.60%	1,170,443	18.12%	917,881	14.21%	57,489	0.89%	543,881	8.42%	4,122,389	72.24%	38,352	50,817
25		Iowa	3,045,700	234,519	7.70%	710,562	23.33%	203,757	6.69%	914,319	30.02%	973,406	31.96%	548,531	18.01%	450,459	14.79%	25,584	0.84%	133,097	4.37%	1,997,979	69.97%	19,563	19,009
26		Kansas	2,817,700	250,775	8.90%	649,480	23.05%	195,548	6.94%	845,028	29.99%	889,830	31.58%	380,671	13.51%	391,660	13.90%	70,443	2.50%	240,068	8.52%	1,732,604	70.01%	18,080	20,306
27		Kentucky	4,307,000	521,147	12.10%	843,741	19.59%	195,538	4.54%	1,039,279	24.13%	1,155,568	26.83%	1,167,628	27.11%	648,204	15.05%	61,159	1.42%	234,732	5.45%	3,032,559	75.86%	22,236	33,953
28		Louisiana	4,541,600	535,909	11.80%	832,929	18.34%	262,504	5.78%	1,095,434	24.12%	1,141,304	25.13%	1,283,910	28.27%	576,329	12.69%	68,124	1.50%	376,953	8.30%	3,069,667	75.89%	23,438	34,901
29		Maine	1,300,000	106,600	8.20%	269,750	20.75%	84,110	6.47%	353,860	27.22%	369,460	28.42%	235,820	18.14%	216,840	16.68%	22,360	1.72%	101,790	7.83%	844,480	72.79%	7,571	7,834
30		Maryland	5,892,900	553,933	9.40%	1,397,207	23.71%	329,413	5.59%	1,726,620	29.30%	1,913,425	32.47%	1,050,115	17.82%	733,077	12.44%	107,840	1.83%	362,413	6.15%	3,804,456	70.71%	36,942	43,822
31		Massachusetts	6,620,700	529,656	8.00%	1,542,623	23.30%	356,856	5.39%	1,899,479	28.69%	2,112,665	31.91%	1,564,471	23.63%	826,925	12.49%	34,428	0.52%	182,069	2.75%	4,538,490	71.30%	40,641	41,029
32		Michigan	9,720,300	923,429	9.50%	2,108,333	21.69%	524,896	5.40%	2,633,229	27.09%	2,886,929	29.70%	2,181,235	22.44%	1,464,849	15.07%	55,406	0.57%	498,651	5.13%	6,588,419	72.91%	56,340	67,542
33		Minnesota	5,446,600	375,815	6.90%	1,321,890	24.27%	315,358	5.79%	1,637,248	30.06%	1,810,450	33.24%	943,896	17.33%	771,783	14.17%	40,305	0.74%	243,463	4.47%	3,566,434	69.95%	35,030	30,502
34		Mississippi	2,884,500	392,292	13.60%	511,133	17.72%	172,782	5.99%	683,915	23.71%	700,068	24.27%	704,972	24.44%	386,811	13.41%	60,286	2.09%	348,448	12.08%	1,852,137	76.29%	14,633	25,113
35		Missouri	5,921,300	603,973	10.20%	1,287,883	21.75%	414,491	7.00%	1,702,374	28.75%	1,763,955	29.79%	881,089	14.88%	948,592	16.02%	88,820	1.50%	536,470	9.06%	3,682,456	71.25%	36,424	46,883
36		Montana	1,022,600	68,514	6.70%	188,158	18.40%	95,818	9.37%	283,976	27.77%	257,695	25.20%	197,669	19.33%	167,911	16.42%	22,293	2.18%	93,057	9.10%	645,567	72.23%	6,076	5,137
37		Nebraska	1,859,300	148,744	8.00%	436,006	23.45%	147,071	7.91%	583,076	31.36%	597,207	32.12%	231,669	12.46%	249,146	13.40%	37,744	2.03%	160,458	8.63%	1,115,766	68.64%	12,475	12,594
38		Nevada	2,946,500	265,185	9.00%	612,577	20.79%	157,048	5.33%	769,626	26.12%	838,869	28.47%	558,362	18.95%	400,724	13.60%	53,332	1.81%	325,883	11.06%	1,851,286	73.89%	16,467	18,702
39		New Hampshire	1,297,000	88,196	6.80%	313,615	24.18%	72,113	5.56%	385,728	29.74%	429,566	33.12%	179,245	13.82%	217,248	16.75%	11,673	0.90%	73,410	5.66%	837,732	70.25%	8,253	7,082
40		New Jersey	8,823,900	697,088	7.90%	2,084,205	23.62%	500,315	5.67%	2,584,520	29.29%	2,855,414	32.36%	1,511,534	17.13%	1,152,401	13.06%	46,767	0.53%	673,264	7.63%	5,566,116	70.71%	55,298	55,128
41		New Mexico	2,038,100	214,001	10.50%	311,829	15.30%	98,440	4.83%	410,270	20.13%	426,982	20.95%	684,394	33.58%	287,984	14.13%	42,596	2.09%	186,079	9.13%	1,441,956	79.88%	8,778	11,631
42		New York	19,315,800	1,719,106	8.90%	4,023,481	20.83%	1,139,632	5.90%	5,163,113	26.73%	5,512,729	28.54%	5,081,987	26.31%	2,362,322	12.23%	86,921	0.45%	1,108,727	5.74%	13,043,960	73.27%	110,469	124,070
43		North Carolina	9,948,800	955,085	9.60%	1,945,985	19.56%	713,329	7.17%	2,659,314	26.73%	2,665,284	26.79%	1,830,579	18.40%	1,452,525	14.60%	272,597	2.74%	1,068,501	10.74%	6,220,985	73.27%	56,898	68,929
44		North Dakota	726,000	58,806	8.10%	177,725	24.48%	65,993	9.09%	243,718	33.57%	243,428	33.53%	77,827	10.72%	94,888	13.07%	11,689	1.61%	54,523	7.51%	427,832	66.44%	5,215	5,330
45		Ohio	11,323,500	1,075,733	9.50%	2,488,905	21.98%	546,925	4.83%	3,035,830	26.81%	3,408,374	30.10%	2,386,994	21.08%	1,730,231	15.28%	100,779	0.89%	661,292	5.84%	7,626,377	73.19%	64,954	77,869
46		Oklahoma	3,803,700	406,996	10.70%	727,267	19.12%	223,277	5.87%	950,545	24.99%	996,189	26.19%	684,286	17.99%	560,665	14.74%	80,258	2.11%	531,757	13.98%	2,321,398	75.01%	20,338	27,461
47		Oregon	4,063,100	390,058	9.60%	806,932	19.86%	290,512	7.15%	1,097,443	27.01%	1,105,570	27.21%	929,637	22.88%	616,779	15.18%	39,006	0.96%	274,666	6.76%	2,690,991	72.99%	23,481	28,446
48		Pennsylvania	12,389,200	1,090,250	8.80%	2,729,341	22.03%	732,202	5.91%	3,461,542	27.94%	3,737,822	30.17%	2,444,389	19.73%	1,987,228	16.04%	73,096	0.59%	685,123	5.53%	8,242,535	72.06%	74,062	82,246
49		Rhode Island	1,016,000	80,264	7.90%	219,659	21.62%	60,858	5.99%	280,518	27.61%	300,838	29.61%	239,268	23.55%	141,224	13.90%	8,534	0.84%	45,618	4.49%	689,864	72.39%	6,002	5,983
50		South Carolina	4,864,700	510,794	10.50%	930,617	19.13%	297,233	6.11%	1,227,850	25.24%	1,274,551	26.20%	922,347	18.96%	785,163	16.14%	112,861	2.32%	541,441	11.13%	3,094,922	74.75%	26,271	34,810
51		South Dakota	837,000	70,308	8.40%	184,559	22.05%	73,740	8.81%	258,298	30.86%	252,858	30.21%	114,585	13.69%	120,361	14.38%	13,559	1.62%	77,339	9.24%	501,363	69.14%	5,526	5,858
52		Tennessee	6,538,200	745,355	11.40%	1,313,524	20.09%	389,677	5.96%	1,703,201	26.05%	1,798,659	27.51%	1,342,946	20.54%	952,616	14.57%	125,533	1.92%	615,245	9.41%	4,219,754	73.95%	36,441	52,425
53		Texas	27,621,200	3,093,574	11.20%	5,540,813	20.06%	1,671,083	6.05%	7,211,895	26.11%	7,587,544	27.47%	4,701,128	17.02%	2,839,459	10.28%	475,085	1.72%	4,806,089	17.40%	15,603,216	73.89%	154,304	218,088
54		Utah	3,047,400	228,555	7.50%	773,125	25.37%	273,961	8.99%	1,047,087	34.36%	1,058,667	34.74%	340,090	11.16%	291,331	9.56%	35,045	1.15%	274,875	9.02%	1,725,133	65.63%	22,403	21,204
55		Vermont	600,200	42,614	7.10%	117,339	19.55%	29,290	4.88%	146,629	24.43%	160,674	26.77%	168,716	28.11%	95,012	15.83%	4,081	0.68%	25,088	4.18%	428,483	75.57%	3,137	2,811
56		Virginia	8,140,600	781,498	9.60%	1,843,846	22.65%	562,515	6.91%	1,843,846	22.65%	2,526,028	31.03%	968,731	11.90%	1,129,101	13.87%	390,749	4.80%	719,629	8.84%	5,014,610	70.44%	39,451	47,792
57		Washington	7,239,800	557,465	7.70%	1,581,896	21.85%	440,904	6.09%	2,022,800	27.94%	2,166,148	29.92%	1,505,154	20.79%	960,721	13.27%	144,796	2.00%	440,180	6.08%	4,776,820	72.06%	43,279	42,054
58		West Virginia	1,762,000	220,250	12.50%	318,570	18.08%	65,723	3.73%	384,292	21.81%	436,447	24.77%	493,536	28.01%	323,679	18.37%	22,554	1.28%	101,315	5.75%	1,276,217	78.18%	8,222	12,970
59		Wisconsin	5,643,000	417,582	7.40%	1,346,984	23.87%	338,580	6.00%	1,685,564	29.87%	1,844,697	32.69%	948,588	16.81%	834,600	14.79%	40,065	0.71%	289,486	5.13%	3,667,950	70.13%	36,064	33,678
60		Wyoming	563,400	42,818	7.60%	123,948	22.00%	37,297	6.62%	161,245	28.62%	169,752	30.13%	71,101	12.62%	80,115	14.22%	12,000	2.13%	69,186	12.28%	332,969	71.38%	3,450	3,309
61		Puerto Rico (5)	3,304,900	568,443	17.20%	326,194	9.87%	283,891	8.59%	610,085	18.46%	446,822	13.52%	1,549,007	46.87%	454,093	13.74%	20,490	0.62%	224,733	6.80%	2,470,413	81.55%	13,053	28,332
62		Totals:	320,327,700								27.10%												72.76%	1,850,507	2,216,268
63
64		Sources:
65		(1) Number of people and percentages on each plan type is from Kaiser Family Foundation (2017)
66		(2) Split employer plan types from Kaiser Family Foundation into Employer Group and Employer Self-funded using 57.8% self-funded rate from EBRI (2016)
67		(3) State population is an aggregation of the number of people on each plan type from Kaiser Family Foundation (2017)
68		(4) Percentage of people with diabetes is from CDC's "Diabetes Report Card" (2017)
69		(5) Percentage of people with diabetes in Puerto Rico via CDC BRFSS Prevalence & Trends Data (2017)
70		(6) U.S. Rate of Insulin Dependence calculated from 7 Million insulin dependent people with diabetes divided by the U.S. population
71		(7) The percentage of people with diabetes using insulin is from the NIDDK estimate of 14% of people with diabetes use insulin only and an additional 13% of people with diabetes use insulin & oral medication.
72
73		Who Will be Impacted by a state $100 co-pay cap bill?:
74		Employer - Small/ Large Group: Yes
75		Marketplace: Yes
76		Employer - Self-Funded: No, subject to federal laws under ERISA
77		Medicaid + other govt assistance plans: No, generally public coverage programs in partnership with state and federal govt. Not regulated by state's insurance regulations.
78		Medicare: No, federal program
79		TRICARE + VA: No, military programs
80		Uninsured: No
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