Arizona Reinstates Medicaid Insulin Pump Coverage: A Triumph in Patient Advocacy!

Great news: the Arizona State Legislature has approved the restoration of insulin pump coverage for adults in the state’s Medicaid program (known as AHCCCS)! This is partially thanks to an enormous patient-led Twitter campaign over the past few weeks to educate and encourage Arizona state politicians, and I couldn’t be more thrilled.

Sample screenshot of diabetes advocates reaching out to the AZ Senate

Background on why this is such great news: a couple years ago, Arizona stopped covering insulin pumps for adults on Medicaid. This meant that if you were on Medicaid and you either needed or already depended on an insulin pump, the state would stop paying for it as soon as you turned 21. Considering the proven benefits of insulin pumps (see a round-up of studies here — just select “clinical summaries”), this was a really unfortunate — and economically foolish — decision. Insulin pumps are instrumental in helping people with diabetes to avoid long-term complications, and their long-term benefits outweigh the short-term costs. 

As you can see in my previous blog post on the subject, there’s been a lot of back and forth going on — first the House included insulin pumps in its proposed budget, then the Senate stripped it out, then the House rejected the Senate’s budget, then they went to reconciliation, then the New York Times published its unfortunately timed piece that made it seem like insulin pumps were superfluous gadgets . . . and then yesterday, against pretty substantial odds, I got news that the legislature had included insulin pump coverage in its final budget. (And then I got all teary thinking about how amazing it is that our efforts on Twitter might have played some role in helping other people with diabetes get access to pumps.) 

Interestingly, none of the other so-called “optional” health-related amendments included in previous versions of the budget (including dental, podiatric, chiropractic and broader orthotics coverage) survived — which implies that the patient advocate Twitter campaign really made a difference in demonstrating the importance of insulin pumps.

Some important (and exciting) details: 

-there is no spending cap on the benefit

-this is not a one-year fix — the benefit will remain in place unless a deliberate action is taken to remove it. Considering that the total cost to the state is an estimated $105,000 per year (less than the cost of 6 hypoglycemia-related hospital admissions, according to the American Journal of Managed Care) I am hopeful that this will not happen.

Governor Brewer is expected to sign the budget by Friday. Technically the state fiscal year starts July 1, but its Medicaid program operates on the federal schedule (which starts October 1) — unclear how that’ll affect the start date for coverage. But sit tight: it’s coming! 

I want to extend a huge thank you to the legislatures who helped make this happen, including AZ Representative Heather Carter and Senator Dr. Kelli Ward (who are two of the people I know were the most supportive — though I’m sure there were others and I thank them as well). 

If you would like to express your appreciation on this issue, consider sending a Tweet to: 

@azhousegop @azsenategop @heathercarteraz @kelliwardaz

As well as: @andy_tobin @frankpratt @jeffdial @dgoodale @EthanforHouse @votemccomish @adamdriggs @bob_worsley @senstevepierce

And thank YOU, the diabetes community, for helping spread the word about this issue. When you combine the success in Arizona with last week’s first-ever patient/FDA live chat AND the number of insulin pump-related comments on the Medicare docket on competitive bidding (78 out of 179 are about insulin pumps!), it’s clear that patient advocates can make — and are making — a difference.

On the right is Bennet Dunlap, father of two children with Type 1 diabetes, and creator of StripSafely.com, a patient-led grassroots effort to bring awareness to the issue of glucose meter and test strip accuracy. In the middle is Courtney Lias, PhD, the Director of the FDA’s Division of Chemistry and Toxicology Devices – the division that regulates the blood glucose meters that people with diabetes rely on each day. On the left is Dr. Helene Clayton-Jeter from the FDA’s Office of Health and Constituent Affairs, which organized and coordinated the event, in collaboration with Dunlap and the FDA’s Office of External Affairs, as part of its Patient Network program.

 

Sample Comments in Response to CMS (Medicare) Call for Public Comment on Competitive Bidding (Note: this was not supposed to be exclusively about insulin pumps)

Add a comment

Your email address will not be published. Required fields are marked *

*

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

***The opinions and views expressed in this blog belong to the individual contributor and not to ASweetLife or its editors. All information contained on this blog is intended for informational purposes only. The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.