With this series we will bring you the latest news in diabetes advocacy and policy. This week we cover news updates in insulin affordability, government and legislation, stigma and society, and insurance and access to care.
The Senate Finance Committee released a report in January focused on insulin prices in the US. According to Beyond Type 1, their overall finding was that “too many entities - manufacturers, pharmacy benefit managers (PBMs), and insurance companies - are driving up the cost of insulin.”
Why it matters: Understanding the complexities of insulin pricing in the US and identifying the stakeholders contributing to rising prices is vital in working to address insulin affordability. The Senate report is a promising step towards federal legislative action to cut insulin prices.
Because there is a lack of federal drug pricing reform, policymakers are working to address drug affordability at the state level. Policymakers are proposing legislation that penalizes pharmaceutical companies for “unjustified price hikes” and that creates drug price caps to limit costs.
Why it matters: The Biden administration will likely focus on drug pricing reform, but addressing COVID-19 is their top priority. State lawmakers need to take action against the rising cost of insulin and other life-saving drugs at the state-level if we hope to gain traction in drug pricing reform anytime soon.
Government and Legislation
The Trump administration’s rebate rule, meant to go into effect in 2022, has been delayed for a year in response to a lawsuit filed by major pharmacy benefit managers (PBMs). This regulation aims to eliminate drug rebates from pharmaceutical companies to PBMs for Medicaid and Medicare Part D.
Why it matters: Drug rebates given to PBMs are one reason for the rising cost of diabetes medications. The rebate rule could help to lower drugs costs by eliminating these rebates. Learn more about drug rebates here.
The Centers of Medicare and Medicaid Services opened a special enrollment period for the Affordable Care Act insurance marketplace. The 3-month enrollment period began February 15th and will end May 15th.
Why it matters: Before the COVID-19 pandemic, over 35 million Americans were uninsured. Since then, millions have lost health insurance due to COVID-related job loss. CMS is making a concerted effort to raise awareness about this special enrollment period to support uninsured Americans in finding healthcare coverage.
Introduced at the end of January, a sugar sweetened beverage tax in Washington state calls for “a statewide $0.0175 per ounce tax on sugary drinks to expand investments in health equity and public health programs.”
Why it matters: COVID-19 has highlighted healthcare’s stark racial inequity. Food and nutrition policies that support historically marginalized and underserved communities are crucial.
The Protecting Access to Post-COVID 19 Telehealth Act was recently reintroduced by several US representatives. The bill aims to protect access to telehealth after the COVID-19 pandemic by eliminating geographic restrictions, extending telehealth reimbursement, and calling for more research on the impact of telehealth during the pandemic.
Why it matters: The expansion of telehealth during the COVID-19 pandemic has shed light on the value of virtual care. Making telehealth expansion permanent will allow for safer, easier, and more effective healthcare access for millions of people with diabetes. If passed, this bill will help to preserve the telehealth access we have seen during the pandemic.
What you can do: Join diaTribe Change in advocating for the permanent expansion of telehealth access to keep people with diabetes safe and healthy. Click here to take action.
Stigma and Society
Severe COVID-19 cases have been linked to new cases of diabetes. According to this study published in November, out of 3,700 hospitalized patients, 14.4% were recently diagnosed with diabetes.
Why it matters: People with diabetes are at a higher risk for severe COVID-19 complications, and these findings indicate that COVID-19 could contribute to the growth of the diabetes epidemic.
What's next: These preliminary studies will likely motivate more research on the relationship between severe COVID-19 cases and new diabetes cases.
According to this study, between 2013 and 2016, obesity likely contributed to an estimated 53% of new cases of type 2 diabetes. The impact of obesity on diabetes varies significantly by sex and race/ethnicity.
Why it matters: This research highlights the extent to which the obesity epidemic impacts rates of type 2 diabetes in the US. A more concerted effort to prevent obesity would also help prevent new diabetes cases.
Insurance and Access to Care
A coalition of health industry leaders, including the American Medical Association and the US Chamber of Commerce, are urging Congress to support the Biden Administration in expanding healthcare coverage in the US. The Affordable Coverage Coalition released a group of legislative proposals including incentives for Medicaid expansion and an increase in federal subsidies for health insurance coverage.
Why it matters: The Biden Administration plans to build upon the Affordable Care Act by establishing a public healthcare option. With well over 30 million uninsured Americans, we need federal healthcare reform. It is encouraging to see this coalition of health industry leaders support the expansion of healthcare coverage in the US.
The $1.9 trillion COVID relief bill supported by the Biden Administration includes several changes to the ACA in order to temporarily expand healthcare coverage in the US. Some of these changes include increased eligibility for federally subsidized healthcare and incentives for Medicaid expansion.
Why it matters: During the COVID-19 pandemic it is estimated that 27 million people lost their employer sponsored health insurance. In a time where access to healthcare is more important than ever, we need legislation that will support the millions of uninsured Americans. If passed, this COVID relief bill will help increase insurance coverage during the pandemic.
What's next: The COVID-19 relief bill is still being considered in the House of Representatives but could be passed within 1-2 weeks and moved to the Senate. Democratic leaders are pushing to have the relief bill signed into law by mid-March.
As the administrator of the Centers for Medicare and Medicaid Services (CMS), Brooks-Lasure would oversee Medicare, Medicaid, the Children’s Health Insurance Program, and the Affordable Care Act (ACA). She would be the first Black woman to lead CMS.
Why it matters: Congress is not likely to support Biden’s progressive plan for healthcare reform, leaving CMS as the Administration's main resource for healthcare reform. Brooks-Lasure was a key drafter of the ACA and is well positioned to support Biden’s plan to protect and expand the ACA and increase access to healthcare in the US.
What's next: Brooks-LaSure must be approved by the Senate before she can assume the role as the administrator for CMS.