Massachusetts, Alaska Join States In Mandating Diabetes Coverage

Diabetics with insurance can now count on having their health plans cover the disease in 40 states. Massachusetts Gov. Paul Cellucci Thursday (5/4) and Alaska Gov. Tony Knowles last month signed bills that require health insurers to provide coverage for diabetes.

Of the 10 states without mandated coverage of diabetes, Hawaii is closest to extending coverage. The Hawaii legislature on the last day of its 2000 session, May 2, passed a bill requiring managed care and other health plans to cover outpatient services, equipment and supplies for diabetics. The bill is on its way to the desk of Gov. Ben Cayetano. Kathleen Racuya-Markrich, Cayetano’s spokesperson, said the governor is undecided about signing it.

Alabama, Delaware, Idaho, Michigan, Montana, North Dakota, Ohio, Oregon and Wyoming are the nine other states that do not presently require health plans to cover the disease.

Many of the 40 laws in place are similar in what they cover: equipment, supplies and self-management training. A few of the most recent laws enacted have added medical nutrition therapy, according to Richard Cauchi, senior health care policy specialist with the National Conference of State Legislatures.

The federal Centers for Disease Control and Prevention estimates that 15.7 million people have diabetes, and 5.4 million of those cases are undiagnosed. There are 798,000 new cases diagnosed every year. An estimated $98 billion is spent annually on the direct and indirect costs of diabetes.

The average costs for equipment and supplies per year for diabetics is about $250 for glucose monitoring supplies and $270 for insulin, according to Mike Mawby, vice president of government relations for the American Diabetes Association.

Diabetes, which is either a lack of insulin in the body or an inability to use it that causes sugar (glucose) to build up in the blood, is classified into types: Type 1 (juvenile onset) and Type 2 (adult onset). While Type 1 diabetics take insulin for treatment, only some Type 2 diabetics require insulin. But both patient types are supposed to monitor their blood glucose levels frequently.

Many diabetics can manage the disease themselves, and it is these self-management treatments, such as insulin injections, blood testing supplies and education on monitoring the disease, that most states now cover.

Though he says the evidence is strictly anecdotal, Mawby says the impact of states’ laws has been positive.

“People tell us they’re getting coverage for things that they weren’t getting covered for before,” he said.