Tariffs and People with Disabilities
Trump’s proposal to impose tariffs on imported pharmaceutical products is more than bad policy. It’s a direct hit to people with disabilities who already navigate a healthcare system full of landmines.
These proposed tariffs won’t improve access. They won’t magically create domestic manufacturing capacity. They will raise prices and limit the supply of the medications that keep millions of disabled people alive and functional — especially insulin, heparin, and generic drugs.
Insulin: Already Too Expensive, Now Potentially Pricier
Let’s start with insulin.
People with Type 1 diabetes, like me, do not produce insulin. We will die without an outside source of insulin. That’s not an exaggeration; that is medical reality. Many Type 2 diabetics are also insulin-dependent. Trump’s proposal would impose tariffs on imported insulin, a huge portion of the U.S. supply. This would raise prices in a market that already gouges patients. You might be thinking, “Didn’t Biden pass a $35 per month cap on insulin?” Unfortunately, that wasn’t for all insulin, and it only helps people with insurance who are injecting insulin directly and not using insulin pumps, a tool that reduces diabetic complications and costs.
In 2023, the average list price for a month’s supply of insulin was over $300 without insurance. The exact same insulin in Canada is under $30 USD, one-tenth the price. price. Many type 1 diabetics ration insulin, a dangerous and life-threatening behavior caused by lack of access, not lack of responsibility. Don’t even get me started on the fact that if you walk into an ER and ask for insulin to prevent kidney damage, security will escort you out. If you wait until your kidneys are damaged from lack of insulin and go to the ER, you automatically qualify for Medicare and a $250,000 kidney transplant. The perverse nature of the opposite sides of this coin was the central theme for my MBA thesis which focused on health care management.
TL;DR: Tariffs will hit disabled people the hardest. We can’t just “shop around” for an alternative. We can’t substitute something else. We can’t wait for the market to stabilize. Our bodies don’t work that way. Delayed or reduced insulin can cause diabetic ketoacidosis in hours, with hospitalization or death coming shortly after that.
Heparin and Penicillan: No U.S. Supply, No Safety Net
Now let’s talk about heparin. Most Americans probably don’t know what it is unless they’ve been hospitalized. People with clotting disorders, those receiving dialysis, and many surgical patients depend on heparin to prevent deadly blood clots. One-third of people hospitalized in the US receive heparin every year, about 12 million people. Heparin costs under $1 USD per dose.
The U.S. imports the vast majority of its heparin from China because heparin comes from pigs, and China is the world’s largest pork producer. There is no meaningful US-based production of heparin. There’s also no way to flip a switch and make it happen quickly.
The proposed tariffs on penicillin would raise the price of one of the most widely used and oldest antibiotics, affecting both availability and cost for patients and healthcare providers. The United States currently imports 80 % of its penicillin from China, which has lower costs and fewer environmental restrictions. Reinstating domestic production is not a quick or easy fix. There is a years-long factory setup timeline, and a very small number of facilities in the US currently capable of manufacturing antibiotics. The increased costs from tariffs could lead to shortages, especially in low-income and rural areas, and strain safety-net healthcare systems that rely on low-cost generics. This would reverse decades of progress in infectious disease management and create a ripple effect across hospital formularies and outpatient treatment protocols.
The impact of tariffs on penicillin is exacerbated by reduced research funding for new classes of antibiotics. Most pharmaceutical companies have abandoned antibiotic development because it is costly, time-consuming, and does not have a high profit margin like Ozempic or biologics that patients are on indefinitely. As resistance to older antibiotics increases, the lack of investment in alternatives results in fewer backup options when penicillin becomes inaccessible or ineffective. This leaves clinicians with limited tools to treat common infections, heightening the risk of complications, hospitalizations, and even death. The combination of supply chain disruptions, economic policy decisions, and a stalled drug pipeline creates a significant vulnerability in the public health system.
Tariffs don’t build factories or capacity. What they do is create supply shortages, drive up prices, and send ripples through the health system, delaying procedures or reducing the availability of life-saving care. If you are one of the 12 million people in the us who needs heparin to avoid dying, you don’t have the option to wait out a global trade standoff.
Generics
Generic medications are the affordable backbone of disability healthcare in the U.S. American doctors use generics to treat seizures, psychiatric conditions, chronic pain, high blood pressure, and infections. For many of us, switching to a brand-name drug is not just unaffordable, it’s impossible. Insurance plans often won’t cover the brand name if a generic exists, and pharmacies may not carry alternatives if tariffs create regional shortages.
Almost all generics are imported. Many come from India or China. This is because generics are cheap, and there is no profit margin when produced in areas with high labor costs. Tariffs mean price hikes, supply disruptions, and an increased risk of counterfeit or substandard drugs entering the market.
For disabled people living on fixed incomes, tariffs are not a political issue; they are a survival issue.
Tariffs Are Not a Disability-Neutral Policy
Let’s be blunt. If you propose a sweeping policy like pharmaceutical tariffs without evaluating how they will affect disabled people, that’s ableism.
People with disabilities are not expendable. We are not edge cases. We are not “unintended consequences.”
Disabled people make up almost one-quarter of the U.S. adult population. We are the largest minority group in the country. We are more likely to be poor, unemployed, underinsured, and dependent on government-sponsored health care insurance like Medicare or Medicaid. A policy that raises the cost of medications hits us first and hardest.
When people with disabilities can’t access medications, they don’t just get sicker; they get more disabled. They die younger. They lose independence. They lose the ability to work, parent, and live outside hospitals and nursing homes. They stop paying taxes, which reduces the amount of income the government has to spend.
Viable Alternatives
There are more effective ways to tackle the issues that Trump’s tariffs purport to address. All these approaches begin with engaging the disability community in the discussion.
Invest in domestic manufacturing — with a timeline and a plan. Build capacity before you cut off supply.
Mandate price caps for essential medications. Especially for drugs like insulin and heparin that people cannot live without. There is something fundamentally broken with a system where Americans are traveling to Canada and Mexico to buy the drugs they can’t afford in the US.
Increase FDA oversight of foreign suppliers. That’s a more effective way to ensure safety than slapping on a blanket tariff to force production domestically.
Include disabled people in health policy decisions. We are the experts in the consequences of inaccessibility, not politicians.
Tariffs on medications are not an abstract issue. They are a direct attack on the health and lives of disabled people. If you ignore that, you are telling us — loudly and clearly — that we don’t matter.
We categorically reject that.