Mary Clark, a realtor in Cincinnati, has grown accustomed recently to being the center of attention at the pharmacy. An independent contractor, Clark has had trouble finding affordable health insurance that covers the costs of the insulin she needs to control her Type 1 diabetes. Since 2012, she’s noticed the price she must pay out-of-pocket has increased steeply; it’s been a big enough leap that even the pharmacists pause in their work when filling her order. “Everyone was just stunned and they would just stand and stare at me,” Clark says.

She knows many other people with diabetes that are in the same situation, especially those who use long-acting insulin like Lantus. She says she can’t afford pump therapy and she has cut out all other expenses, including doctor’s visits and dental care, to keep up with the cost of insulin.