When's 26-year-old son died, he had just moved out of his parents' home and was starting a life of his own.
"The hardest part is every time I tell the story, it's like reality slaps me in my face that my son is no longer here," Smith-Holt told CBS News correspondent Anna Werner.
Her son, Alec, was a Type 1 diabetic – someone who needs to take insulin every day to survive. But turning 26 meant his parents' insurance would no longer cover the cost, shooting his monthly cost for insulin and supplies up to $1,300 per month, according to his mom.
"My son died because he could not afford his insulin," she said.
What she said Alec didn't tell her was that he was struggling with that cost. He'd started trying to ration his insulin to make it last longer. It wasn't enough. He died after falling into a diabetic coma alone in his apartment.
"Nobody to be there with him, to hold his hand or to call for help … and then I think about if he had never moved out, if he had lived at home, somebody would've, you know, seen the signs," Smith-Holt said. "And I'll probably feel guilty every day for the rest of my life."
Even though Alec never told her he was struggling to pay for his insulin, she still feels like she should have known. She said she's dealing with that guilt by advocating for other Type 1 diabetics.
"I deal with my own grief and my guilt by fighting for the lives of others," she said.
The drug industry is starting the New Year byon hundreds of prescription medications despite pressure from President Trump. A group that tracks drug costs said about 60 companies increased the price on almost 300 medications.
The price of insulin, a life-saving drug for diabetics, tripled between 2002 and 2013. Since 2008 three of the top makers raised the list price of insulin at least 10 times. Now, the state of Minnesota is taking action by suing three of the world's largest insulin manufacturers.
Lori Swanson is Minnesota's attorney general. She's now suing the top three insulin manufacturers for what she calls "deceptive, misleading, and misrepresentative list prices."
"I think in America nobody should lose their life because they can't afford the cost of insulin," Swanson said. "They've raised the price of insulin by being in cahoots with the pharmacy benefit managers and having a secret price for them that the public doesn't get."