My husband has Crohn’s disease, an inflammatory bowel disease characterized by debilitating and sometimes life-threatening inflammation of the gastrointestinal tract. It requires medical intervention, often including major surgery and biweekly infusions at a hospital or clinic. At the time of my husband’s diagnosis, a ground-breaking drug called Humira (adalimumab) had hit the market. The invention of Humira was a game-changer for people with Crohn’s and other serious autoimmune disorders, due to its efficacy and ease of at-home administration. The catch: Humira is one of the most expensive drugs in the world. Before insurance payments, it could cost up to $7,000 per month. From 2002 to 2022, it used over 100 patents to maintain the exclusive right of manufacture for 20 years. During this time, its robust assistance program meant most patients paid nothing for the medication. After its patents were exhausted, a range of generics, or biosimilars, were launched. This sounds like good news, right? Nope. While the generics have a lower price tag, ranging from $1.500 to $3.500/month, the cost is obviously still unaffordable for most people. That’s where insurance comes in, right? Not so fast. With the generics came the loss of comprehensive assistance programs. Because the astronomical cost of adalimumab puts it in the “specialty drugs” category, most insurers will only cover it at 50-70% after the deductible is met. This means patients are stuck with a $500+ copay after the relatively poor assistance coverage is capped, until they meet their yearly out-of-pocket maximum. My husband and I are on Connecticare marketplace insurance, because we are both contractors. Even with the lowest tier of available insurance, we pay about $1,300/month in premiums. This is already unaffordable for many families, a systemic problem that I will not be addressing here. Our individual out-of-pocket max is $9,200, or a total of $18,400 for our two-person family. With the cost of my husband’s medication and our premiums, we may pay up to $25,000 in healthcare costs per year, assuming I have no serious medical needs that year. Compare this to the median per capita income in Connecticut, which is about $56,000. Some of these people are covered by Husky, which carries an individual income cap of just over $10,000/year. This means that a person on marketplace Connecticare who makes the median per capita income in Hartford County could pay almost 45% of their income per year toward medical expenses! We are extremely lucky to be in a position where we can technically afford these healthcare costs. However, others are not so fortunate, and some have to stop taking life-saving immunosuppressants because they simply cannot afford it. This is a serious injustice. In addition to the cost, every month, my husband and many like him must spend hours on the phone convincing Connecticare to even send him his adalimumab to begin with. Three months into the year, he was forcibly switched from Hartford Healthcare’s specialty pharmacy to CVS specialty pharmacy, taking away his insurance advocate. He has had to take it late four months in a row because of this morbid version of phone tag. While the arrival of generic adalimumab has reduced costs for insurers, it has increased costs for most consumers. One person my husband spoke to on the phone said, “The insurance companies don’t know what to do!” I would argue that yes, they do know the morally correct thing to do – they just don’t care. Their bottom line matters more than the lives of their customers. My husband is not the only person running into these exorbitant costs. Extrapolating from national statistics, approximately 74,000 Connecticut residents take high-cost biologics like adalimumab, and many of these people are facing choosing between their medication and, say, rent or groceries. To be honest, I couldn’t care less about the profits of the insurance companies. The CEO of Molina Healthcare, the parent company of Connecticare, made over $18 million in 2025, not counting stock options, of course. This salary could pay for an entire year’s worth of adalimumab for a thousand people! The entire system is rigged to harm, not help. When healthcare services are rendered for profit, the only people who win are rich executives, while the rest – especially those with chronic illness – suffer. Our legislators at both the state and national levels should be prioritizing this issue, not just for people on expensive specialty medications, but for all. Health insurance premiums alone are out of reach for a large number of Connecticut residents. Obviously, the sustainable solution is universal healthcare, paid for by taxes on millionaires and billionaires. In the meantime (since we know that’s not going to happen in our lifetimes), our lawmakers must force insurers to cap the amount they can extort from their customers. These medications are not luxury goods. They are a necessity for life. Allowing insurers to profit off of human suffering is unacceptable, and we must pressure our representatives to act. Kim Adamski lives in West Hartford.   ...read more read less