Mitch Lerner is a Clintonville resident who has been active in diabetes advocacy causes in Ohio for almost three decades.

There are very few opportunities in today’s politics for senators to cast a clear vote on a narrow and straightforward proposal.

On Aug. 7, however, senators had exactly such an opportunity, when they voted on a Democratic plan to cap co-pays for insulin at $35 a month.

Ohio Sen. Rob Portman voted against that proposal. In doing so, he abandoned more than 1 million Ohioans who have diabetes, including all three of my children.

All of my kids have Type 1 diabetes — the less-common version sometimes known as juvenile diabetes because its onset tends to come at a young age.

In this disease, a person’s autoimmune system destroys the insulin-producing cells in their pancreas, leaving them unable to produce this vital hormone.

More:Rob Portman votes to strike down insulin cap as U.S. Senate Democrats pass spending bill

There is no cure, not diet or exercise or any of the pills you see advertised on late-night television. It is actually quite simple: Without insulin, my children and the almost 2 million others like them across the country would be dead within days.

These people face a lifetime of insulin injections and blood tests just to stay alive, and even then, they live each day with the constant risk of seizures and terrible sickness, as well as the long-term threat of complications like blindness, kidney failure, and death.

More:How to submit guest opinion columns to the Columbus Dispatch

The demands and hardships of this disease are made worse because diabetes is incredibly expensive in the United States.

While the rest of the industrialized world has passed regulation to ensure access to affordable insulin, the United States has not.

More:Column: Capping the cost of insulin helps those most in need

One vial of rapid-acting insulin, which costs about $5 to produce and could be purchased for $21 in 1999, now routinely exceeds $300 for those without insurance. That same vial can be purchased for $40 in Canada and is almost free in most of Europe.

Even those Americans with good insurance often pay outrageous amounts for this life-saving product. One 2021 study showed that Americans with diabetes pay, on average, 28% of their annual income for insulin, as opposed to 3% in Canada and 4% in Denmark.

The skyrocketing costs have led to a shocking reality: here in one of the wealthiest nations of the world, more than 25% of people with diabetes report rationing their insulin, the highest rate by far among wealthy nations, despite the risk of death that it carries.

Ohio has been hit hard by diabetes.

More:Fact-check: Has the price of insulin 'gone thru the roof'?

More than a million of our neighbors have the disease, which is the eighth most common cause of death in the state; another million have been diagnosed as pre-diabetic.

Portman had a chance to take steps to protect these vulnerable people by casting a vote to ensure that most Americans would face reasonable prices for their life-saving medication.

Seven other Republicans voted in favor of the proposal, including arch-conservatives like Josh Hawley and moderates like Susan Collins.

Portman, however, chose the side of Big Pharma and political partisanship and joined other Republicans to defeat the measure by just three votes.

Like many Ohioans, I was outraged. On Aug. 8, I went to Sen. Portman’s office in search of explanation. The senator’s staff explained that he objected to the process and was worried that including this provision in the reconciliation bill would set “a bad precedent.”

Portman had a chance to protect more than a million Ohioans struggling with a terrible disease, but instead he demonstrated that he was more worried about an arcane process matter in the type of bill that comes to a vote just a couple of times each year than he was about their futures. Thousands of sick kids and their terrified parents no doubt find little comfort in those misplaced priorities.

In 2011, the Juvenile Diabetes Research Foundation honored my family for the advocacy work we do for Type 1 diabetes by bringing us to Washington, D.C., to participate in their semi-annual lobbying campaign.

More:Soaring insulin prices show how the US is losing the battle against high drug costs

The theme that year was “A Promise to Remember Me,” and legislators met with children and their parents to discuss the challenges of living with this disease.

Portman met with my kids and a few others from Ohio that day, and promised to remember them when it came time for future votes about diabetes.

On Aug. 7, he broke that promise, and abandoned millions of Ohioans.

It was a betrayal that many of us will never forget.

Mitch Lerner is a Clintonville resident who has been active in diabetes advocacy causes in Ohio for almost three decades.