ST. PAUL-It is personal for Rod Hamilton. The Minnesota state representative, a multiple sclerosis patient for 20 years, cannot get a committee chairman to consider a bill he says will help people like him who depend on prescription medicine.

"Let's have these debates," Hamilton said Tuesday, March 14. "Don't hide from it; don't cower behind a damned gavel."

The person he talked about, but did not specifically name, is House Commerce Chairman Joe Hoppe, R-Chaska, who says he will not take up Hamilton's bill written to allow patients to generally continue receiving prescription medicine throughout an insurance policy's term.

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Hoppe said that Hamilton's bill would increase the cost of health care, while Republicans who control the House want to cut the cost.

"The heart of the matter is poverty of the human heart," Hamilton said of fellow Republicans' decision to not consider his bill.

Hamilton, of Mountain Lake, who from time to time goes against his GOP colleagues on specific issues, said that a pharmacy benefit manager limits his anti-fatigue medicine to one pill a day even though his Mayo Clinic doctor thinks he needs two a day.

Hamilton said that taking half the dose that his doctor prescribed means he is forced to use a wheelchair and must decide between exercise and work because he becomes too fatigued to do both.

Hamilton pays the entire cost of the medicine, he said, but his pharmacy can only give him 30 pills a month because of the benefit manager's decision.

A year ago, before the medicine cutback, Hamilton used a scooter to go long distances in the Capitol complex, but also could walk short distances.

His bill would limit the power of benefit managers, who control costs for insurance companies, to deny prescriptions during policy's term.

A Senate version of the bill, offered by Sen. Carla Nelson, R-Rochester, has met with bipartisan backing and she said she expects it to pass the full Senate. But Hoppe, who controls the committee where Hamilton's bill must start, said it runs counter to GOP efforts to control health care costs.

"We are not going to have a hearing," Hoppe said. "I am sympathetic. We are all doing all we can to lower the cost of health care."

On the other hand, Hoppe said, he might not oppose a Hamilton effort to attach the provision onto another bill as it moves through the House.

The chairman said that Hamilton's bill may be something that could be studied after this legislative session ends in May, with it resurfacing next year if appropriate.

House speaker Kurt Daudt, R-Crown, agreed with Hoppe that the Hamilton bill likely would increase costs, but said he blames Hamilton's insurance company, not benefit managers.

Daudt said that Hamilton, the House agriculture finance chairman, had not talked to him about the issue.

"If he really wanted his bill to get a hearing, he would be talking to me and not you," the speaker told reporters.

As for his two chairman who do not agree on the issue, Daudt said: "I probably will have to talk to both of them and find out if they have had conversations."

In an emotional talk to reporters said that what really bothered him was a 10:31 p.m. Monday text message he received saying there may be a way to work with a benefit manager to approve the full dose of his medicine.

"I am a legislator making a ruckus about this," he said, adding that "it is not just about me; it is greater than that."

Hamilton, who would not say who sent him the text, indicated that he only was given a chance to get medicine because he is an elected official who was talking about the issue in public. He said that he does not plan to take the person who sent the text up on the offer.

Dr. David Agerter, an Austin physician for Mayo Clinic, said each patient is unique, and others should not change a doctor's decision about the best medicine.

Switching drugs "can threaten a patient's life," he said.