In Detroit, the cost of prescription drugs drives on-the-ground voter outreach

In Detroit, the cost of prescription drugs drives on-the-ground voter outreach

Rates of diabetes and high blood pressure are staggering in Detroit—and cuts to Medicare or Medicaid would make accessing care even more challenging. One political advocate hopes these health care inequities will encourage voter turnout in the city’s urban communities. (Graphic by Kelly Lennon)

By Sophie Boudreau

July 9, 2024

Rates of diabetes and high blood pressure are staggering in Detroit—and cuts to Medicare or Medicaid would make accessing care even more challenging. One political advocate hopes these health care inequities will encourage voter turnout in the city’s urban communities. 

Roquesha O’Neal won’t back down when it comes to her family’s health care. 

In fact, the lifelong Detroiter used to cross the border into Canada to purchase affordable insulin for her mother, a Type 1 diabetic. 

“My mom had struggles with her health care,” O’Neal said. “She had to choose between grocery or insulin because the price was so high.” 

Before President Joe Biden’s Inflation Reduction Act capped the monthly cost of insulin at $35 for elderly patients covered by Medicare, O’Neal would regularly make the brief journey from Detroit to Ontario with help from a social justice organization in the city.

She’s not the only one to cross borders in pursuit of more affordable drugs—in fact, “Canada’s stringent drug pricing regulations help keep medication costs more affordable and accessible,” according to a report from PharmaForum. “As a result, this has provided a lifeline for many Americans with financial relief.”

For O’Neal, the international journey was a no-brainer. 

“When it comes down to my family and their health, we’re going to have to do what we have to do to make sure they’re okay,” she said.

Even with Medicaid funding, insulin access is a challenge in Detroit

Advancements like the Biden administration’s monthly cap on insulin have made a difference for people like O’Neal and her family, but she said there’s still plenty of work to be done—particularly in communities where even significant price cuts aren’t quite enough to ensure all residents have access to prescription drugs and quality medical care. 

And there’s no shortage of demand for insulin in the Motor City. A 2020 study from the National Institutes of Health identified a 12% prevalence of diabetes among adult residents of Wayne County, where Detroit is located. A 2017 report revealed that throughout the state of Michigan as a whole,  diabetes was more likely to affect Black, non-Hispanic adults than white adults. Roughly 77%  of Detroit’s population identifies as non-Hispanic Black. 

In many marginalized communities in Detroit—where some 30% of families live below the poverty line—even the $35 monthly cost for Medicare recipients remains a challenge. O’Neal has heard of diabetics in her community who’ve been forced to choose between purchasing their necessary insulin or putting money toward rent. 

“It should be, like, five dollars, two dollars. It should be easy,” she said. “If you’re low-income, it should be a price that you don’t have to choose between your health care and your groceries or your rent. It shouldn’t be a choice.”

O’Neal worries about the potential impact of cuts to Medicare and Medicaid or rollbacks on progress made for prescription drug access. Former president Donald Trump has repeatedly suggested that he’d be open to cutting Medicare and Social Security funding if he’s elected for a second term in November. 

“We know that we’re going to lose a lot of people, right?” O’Neal said when asked about the impacts of potential health care funding cuts. “That’s the reality.”

If reelected, Biden has vowed to further expand Medicaid and Medicare coverage, “bridge gaps” for low-income families, and ultimately apply the $35 insulin cap to all diabetics in the nation—not just those covered under Medicare. 

When it comes to choosing a candidate, O’Neal said character counts. 

“My main speech is that we need y’all to listen to the people because you were supposed to be working for the people,” she said. “That’s what your job was always for. It’s for the people. So have a heart.”

‘I tell my story for a solution’

By speaking up about health care issues, O’Neal hopes to encourage voter turnout in her community. She points to her own experiences with insurance-related red tape as evidence of a still-imperfect system. 

O’Neal only recently regained health insurance through the state of Michigan after losing her job and spending several months without coverage. During this time, she went three months without medication for her high blood pressure and was ultimately hospitalized to treat a dangerous hypertension spike. 

High blood pressure is a natural point of connection among potential voters in urban Detroit. CDC data shows that Detroit ranks second highest among US cities for hypertension rate, with a prevalence of 47% among adult residents.

While she’s presently insured, O’Neal said, she finds herself in a sort of “limbo” when it comes to long-term health care. While medical issues currently prevent her from working, she’s also not ready to rely completely on state benefits or give up on the possibility of returning to a job. 

“One worker told me, ‘Well, you need to apply for disability,’ but I’m too young to apply for disability. Plus, I feel like I could still do the work. I just can’t do as much work,” she said.

“I don’t just tell my story with a problem. I tell my story for a solution,” she continued. “So it goes back to making sure that we vote, making sure that we have the right voices to speak for us, which is the electoral officials who we vote in office for us to make sure they are for the people.”

Promoting the vote at barbecues, laundromats, and beyond

In Detroit, where only about 50% of registered voters cast a ballot in the 2020 presidential election, O’Neal says that meeting people where they are—literally—is key to promoting civic engagement.

As a precinct delegate for her community, O’Neal chats with neighbors and local business owners to remedy inadequate political literacy, which she calls a “barrier” to boosting voter turnout in the city’s urban areas. Sometimes, this looks like physically showing up at community events—including barbecues and graduation parties—to meet potential new voters in comfortable settings. 

“If I’m at the grocery store, at the local liquor store, if I’m at my local laundromat, the local schools… I’m meeting people where they’re at to have the conversations about voting,” she explained. “Because if we don’t vote, we lose our voice. Not just our voice, we lose our life.”


  • Sophie Boudreau

    Sophie Boudreau is a writer and editor with nearly a decade of experience covering lifestyle, culture, and political topics. She previously served as senior editor at eHow and produced Michigan and Detroit content for Only In Your State.

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