Illinois Now The First State To Require Health Insurance Companies To Cover EpiPens For Kids

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As someone who grew up with allergies, I frequently relied on a battery of medications & inhalers in order to minimize my symptoms. There were times, however, when my desire to pet a cat (which I happen to be severely allergic to) would outweigh any sense of self-preservation. I’d pet the cat & have an allergic reaction that made my eyes look like I’d gone ten rounds with Rocky Balboa.

But other than some considerable nasal discomfort and itchy eyes, I’m lucky. My allergy symptoms are inconvenient, but they aren’t fatal.

There are individuals whose lives are at risk when they are (sometimes unknowingly) exposed to an allergen.

You’re likely familiar with horror stories about those who are deathly allergic to peanuts, or bee stings. Even a faint exposure to the allergen can trigger an anaphylactic reaction.

It can be scary enough to navigate a world in which you must take extreme precautions to avoid what you are severely allergic to. What’s even scarier is that the life-saving treatment for an allergic reaction -the EpiPen- is expensive, and not typically covered by most health insurance companies.

Can you imagine a parent’s anguish in not being able to afford such a life-saving tool for their child with allergies? And the fear that parents must have in knowing that without one, a single accidental allergen exposure could kill their child??

One state is paving the way for parents to be able to equip themselves with EpiPens; Illinois has become the first state to require health insurance companies to cover EpiPen injectors for children.

Photo Credit: WIFR

An EpiPen auto injector is a syringe that contains epinephrine (adrenaline), a substance that narrows blood vessels and opens the airways of the lungs. In addition to allowing the allergy victim to breathe, the epinephrine can also help to reverse extremely low blood pressure, wheezing, severe skin itching, and hives. 

For anyone that suffers from severe allergies, time is of the essence once exposed to the allergen. Having an EpiPen on hand can literally save the individual’s life, whereas waiting for paramedics to arrive might not too late. A life literally hangs in the balance.

EpiPens can vary in cost, but most range from $100 to $600 for a set of two injectors. Although the average price was roughly $100 back in 2008, the cost has increased nearly 450%, due to a monopoly on sales by the pharmaceutical company Mylan.

According to Mylan, the price hikes were necessary due to dramatic changes in the health insurance system, including extremely high deductibles on family insurance plans.

For many families across the country, steep prices on EpiPens make it daunting to purchase them to keep on hand, yet what’s the alternative? 

Thanks to Illinois, it appears that much-needed change might finally be on the horizon.

Photo Credit: The Hill.com

Illinois Governor JB Pritzker has officially signed a law into effect that requires insurance companies to cover the cost of the injectors for children that need them.

The bill, known as House Bill 3435, will take effect January 1, 2020. 

The idea for the bill stemmed from Rep. Jonathan Carroll, D-Northbrook, after his own disturbing experience with the ludicrous cost. He arrived at a local pharmacy to pick up his daughter’s prescription for an EpiPen; she has severe food allergies. He was stunned by the price, as he told told the Chicago Tribune:

I went to pick it up, and I was like, ‘You’ve got to be kidding me’. This is a life-saving medication, and it’s becoming cost-prohibitive for people.

It’s also interesting to note that the bill passed unanimously through both the Illinois House and the state Senate, because why would any human being think an EpiPen would NOT be medically necessary??

State Senator Julie Morrison expressed her enthusiastic support of the bill on the Illinois Senate Democrats website, emphasizing that:

We should be doing everything we can to expand access to affordable lifesaving drugs and medicines.

No child with a serious allergy should be without an epinephrine injector because they cannot afford one.

Although the passing of this bill is certainly a significant step forward, there is still the out-of-pocket cost to consider. Although the bill requires insurance companies to cover the cost of the injectors, it does not specify how low (or, unfortunately, how high) the co-pay can be for the device.

It’s definitely a positive step forward, however, and a vital one. No child should have to go without life-saving treatment for a condition that cannot be avoided.

And although the parents of allergy sufferers are amazingly thorough in minimizing their child’s chances of exposure to an allergen, accidents can happen. Access to essential medicine should be a guaranteed right, not a luxury. 

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