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Nicole Smith-Holt
Insulin Affordability Advocate
Mother of Alec Smith who became one of the leading national advocates for insulin price reform after her son died rationing insulin he could not afford
Overview
Nicole Smith-Holt is an American healthcare affordability advocate from Minneapolis, Minnesota, whose 26-year-old son Alec Smith died on June 27, 2017, from diabetic ketoacidosis after rationing insulin he could not afford. After Alec death, Smith-Holt became one of the most prominent and effective advocates for prescription drug price reform in the United States. She testified before the Senate HELP Committee, appeared in major media outlets, and worked directly with legislators including Senator Bernie Sanders and Minnesota lawmakers to advance insulin affordability legislation. Her advocacy contributed to the passage of the Alec Smith Insulin Affordability Act in Minnesota in 2020, which created an emergency insulin supply program for residents who cannot afford the drug. She has also been a key voice in the national movement that contributed to the insulin price cap provisions in the Inflation Reduction Act of 2022. Smith-Holt has confronted pharmaceutical executives directly at public forums and congressional hearings, putting a human face on the consequences of drug pricing practices that have made the United States the most expensive country in the world for prescription medications.
Key Affiliations
Controversies & Concerns
Testified before Congress that her son died three days before payday because he could not afford insulin that costs under $10 to manufacture
Confronted pharmaceutical executives at public hearings and forums about the human cost of insulin pricing
Advocacy led to the Alec Smith Insulin Affordability Act in Minnesota, creating an emergency insulin access program
Worked with Senator Bernie Sanders and other legislators to advance the Inflation Reduction Act insulin price cap provisions
Related Investigations (1)
Known Associates & Connections
Alec Smith
Son who died at age 26 rationing insulin; his death catalyzed her advocacy
Bernie Sanders
U.S. Senator who worked with Smith-Holt on insulin affordability legislation and HELP Committee hearings
Sources & Documentation
2 documented sources from official records, investigations, and reports
Senate HELP Committee: Testimony of Nicole Smith-Holt(2019)
Minnesota Legislature: Alec Smith Insulin Affordability Act(2020)
Personal Information
Education
Key Timeline
2017-06-27
Son Alec Smith dies at age 26 from diabetic ketoacidosis after rationing insulin he could not afford
2018
Begins national advocacy campaign for insulin affordability and pharmaceutical accountability
2019
Testifies before the Senate HELP Committee about Alec death and the cost of insulin
2020
Minnesota passes the Alec Smith Insulin Affordability Act, establishing emergency insulin access for residents
2022
Inflation Reduction Act caps insulin at $35/month for Medicare patients; Smith-Holt advocacy cited as contributing factor