North Dakota has joined a growing United States movement to limit what people with diabetes pay for insulin, with legislation supported by Republicans and Democrats setting a monthly patient cost cap of $25.
The policy has brought the issue into sharp focus for the Kritzberger family, whose daughter Nina was diagnosed with Type 1 diabetes at the age of seven. Her parents, Ang and her husband, farm sugar beets, soybeans and grains in the Red River Valley, and have spent years managing both the demands of the condition and the financial pressure of medical care.
Ang Kritzberger described the early months after her daughter’s diagnosis as an exhausting period of constant monitoring. She said she slept beside Nina for the first 60 days and checked her blood sugar every two hours, around the clock. A decade later, the family still faces annual out-of-pocket medical costs of at least $8,000 for medicines, supplies and appointments, despite having health insurance.
A cost burden that can affect treatment
The family’s experience reflects a wider affordability problem. For years, rising insulin prices required some people with diabetes to pay hundreds or even thousands of dollars. The financial strain led some patients to ration their insulin, a practice that can have fatal consequences, according to the report.
Insurance does not always protect patients from high bills. People with high deductibles may be required to pay substantial amounts before their cover begins contributing to certain healthcare costs. The North Dakota measure is intended to limit the amount a patient pays for insulin each month, including in circumstances where a deductible might otherwise create a large initial bill.
| Measure | Detail |
|---|---|
| Monthly insulin cap in North Dakota | $25 for patients |
| States with similar measures | 29 states |
| Kritzberger family’s annual out-of-pocket medical costs | At least $8,000 |
Bipartisan agreement on medicine prices
North Dakota’s policy is part of a broader push across the country to shield patients from high medicine costs. The effort has crossed party lines, despite the different approaches traditionally associated with the two major political parties.
“In this case, I think there was broad-enough agreement that this market just wasn’t functioning for folks.”
That assessment came from North Dakota state Senator Sean Cleary, a Republican who co-sponsored the legislation last year. He said Republicans have generally favoured market-based solutions, while Democrats have been more supportive of direct government intervention. The insulin debate, however, produced sufficient agreement for both sides to back a price limit.
The policy debate centres on a basic healthcare concern: patients who need insulin cannot simply stop using it because it becomes unaffordable. For people living with Type 1 diabetes, the treatment is part of daily life, alongside testing, medical appointments and the need to maintain supplies. A cap can reduce the immediate cost faced by patients, although the information available does not set out how the measure affects insurers, manufacturers or the overall price of insulin.
What the policy means for patients
The North Dakota measure does not remove the wider costs associated with diabetes. Families may still face expenses for supplies, consultations and other medicines. The Kritzbergers’ experience illustrates how those costs can accumulate even when a person is insured, particularly for a family already under financial pressure from farming and debt.
- The North Dakota law limits patients’ monthly insulin bills to $25.
- Similar measures have been enacted in 29 states.
- The policy responds to concerns that high insulin costs have led some patients to ration treatment.
- Insurance may still leave families with significant costs for supplies and medical care.
For Nina and her parents, the change is tied to a much larger question about how the United States pays for essential treatment. The family’s experience has helped place the human consequences of insulin pricing alongside the political debate. As more states consider similar limits, the central test will be whether patients can reliably obtain the insulin they need without being forced to choose between treatment and other household expenses.
