On April 30, we joined people with diabetes, caregivers, healthcare providers, diabetes educators, and other advocates at the California State Capitol to campaign for coverage of continuous glucose monitors through Medi-Cal, the state’s Medicaid program.
In 2017, the State Assembly’s Adam Gray introduced a bill that would require Medi-Cal to cover CGMs for the treatment of type 1, type 2, and gestational diabetes when prescribed by a healthcare provider. The bill passed unanimously in both the Assembly and the Senate, signaling strong recognition of the benefits CGM provides to people with diabetes, their families, and the entire healthcare system. Governor Jerry Brown, however, vetoed the bill. He argued the Department of Health Care Services already had the authority to make such a change in Medi-Cal coverage if it deemed it appropriate, making the bill unnecessary.
Assembly Member Gray brought the proposal to the Budget Committee during the April 30 hearing, supported by dozens of individuals and organizations. Testimonies from members of the diabetes community urged California lawmakers to ensure that people with diabetes who receive health care from Medi-Cal have access to CGMs in order to improve daily management of diabetes, reduce health care system spending on hospitalizations and long-term complications, and enhance quality of life.
Unlike conventional blood glucose monitors, a CGM keeps constant track of the user’s blood glucose levels. Through alarm systems, these live-saving devices can alert people with diabetes and their caregivers when their glucose levels rise above or drop below safe thresholds. Such instant updates are crucial in preventing episodes of severe hypoglycemia and hospitalization.
CGMs also improve daily management of diabetes and quality of life by helping to increase the amount of time spent “in-range,” or between 70 and 180 mg/dl. Improved glucose control helps lower A1C and ultimately results in fewer long-term complications that can be costly and life-threatening.
In addition to Medicare, virtually all private health insurance plans cover CGM devices. California is one of seventeen states that does not provide coverage for CGM under the state Medicaid program. More than one in ten adults in California have been diagnosed with diabetes, and the American Diabetes Association’s 2017 “Economic Costs of Diabetes in the US” estimates that the cost of diagnosed diabetes in California is $39.5 billion each year.
We strongly believe in the power of CGM to transform a person’s experience with diabetes. We must afford all people with diabetes equal access to this live-saving technology. Together, we can ensure better outcomes for individuals and critical savings for the health care system as a whole.
Please join us in urging lawmakers in California and the other sixteen underserved states to expand coverage of CGM. You can write to your legislators to advocate for this crucial movement. Click here to send a virtual letter through ADA’s website.
Read diaTribe’s coverage of Medicare’s landmark decision to cover CGM and expert opinions on time-in-range and the benefits of using CGM.
Read more about Bill AB-447 here.
Read more about Medicaid and the distinction between federal and state programs here.