UPDATE: Please Help Arizona’s Legislature Protect Poor People With Diabetes


Update (Monday 3/31): Urgent action required AGAIN — please help!

My celebrations may have been too early — whereas the @AZHouseGOP made the wise decision to reinstate insulin pump coverage for adult Medicaid recipients in Arizona, their colleagues in the Senate (@AZsenateGOP) appear to be on the verge of stripping it back out. 

More specifically: the Senate president wants to strip out all the health-related amendments added by the House — including the part about insulin pumps. The full Senate may make its decision within the next day or two — if not later today (Monday 3/31) — so time is once again of the essence. (They’re not targeting insulin pump coverage directly, so we can still be positive and constructive; they’re just trying to take out what they consider to be “optional” services included by the house. Because living with diabetes is like, totally optional. ) 
Anyway, apparently our efforts with the house generated thousands (yes, thousands!) of tweets to the legislators vocalizing our support — and presumably really made a difference. 
So can we try it with the Senate, too? I’m going to send these tweets: 
@AZSenateGOP Pls keep #insulinpump coverage in budget. AZ lives at stake @votemccomish @kelliwardaz @adamdriggs @bob_worsley @senstevepierce
Can you retweet and/or write your own? And encourage your followers to do the same?
Steve Pierce, fwiw, is a big supporter of pump coverage.
Also, we need to reach Senate President Andy Biggs (abiggs@azleg.gov) and Appropriations Chair Don Shooter (dshooter@azleg.gov), neither of whom appear to have Twitter handles. Please consider sending them an email! I’m going to say, “As a person living with diabetes, I know personally how important access to an insulin pump is in preventing devastating — and expensive — complications from diabetes. Providing insulin pump coverage to Arizona’s adult Medicaid recipients would cost about $105,000 per year, roughly the price of six total emergency room visits. At the moment AZ is the only state besides Alabama not to provide this coverage. Will you join your house colleagues in making the wise decision to reinstate insulin pump coverage for Arizona’s poorest citizens? Your constituents’ lives are at stake.”
Oh, and the relevant journalists (should you want to tweet them as well): 
@JimSmall @TomSprattPHX @JeremyDuda @MuckRack @HankDeanLight @Dennis_Welch 
I was so happy, and now am so frustrated. UUUGHH!!!

Update (Friday, 3/28): On Friday, March 28, the Arizona House passed a budget that restored insulin pump coverage for adult Medicaid recipients. (See the last line of this article.) This is huge news — apparently the legislators received over 200 social media messages about this issue — and I’m confident that our collective efforts made a difference. Thank you to everyone who tweeted and/or contacted Arizona’s politicians to ask for their support. If you have a moment (even if you didn’t participate the first time), would you consider tweeting a thank you to the politicians whose Twitter handles are listed below? There are still some hurdles to go before this becomes an official part of the budget, and we need to continue our encouragements (and express our gratitude). Thank you all — I’m so excited!


I was just alerted to an urgent matter that needs immediate help from the diabetes community. We need to tweet, email and call legislators and journalists in the state of Arizona to encourage the forward-thinking members of the Arizona House of Representatives to pass an amendment providing insulin pump coverage for insulin-dependent Medicaid recipients. 


This is urgent because the House is currently – as in, right this very second – considering amendments to its budget.


 As we all know, insulin pumps (see below for definition) are crucial tools in managing diabetes, which is a complicated, life-long, and potentially deadly disease that can lead to very expensive consequences.  The House is currently considering an amendment that would provide this life-preserving coverage for poor people with diabetes, a population whose needs are so rarely listened to – and who are the least well equipped to advocate for themselves. We need to encourage the Arizona House to do the right thing and support an amendment for insulin pump coverage.




For the past four years, Arizona – in an attempt to close a budget gap – has not been covering insulin pumps for adults on Medicaid (the federal healthcare program for the poor). This means that once you turn 21 – no matter how long you’ve been on an insulin pump, or how important it is to your diabetes management – your insulin pump and its supplies will no longer be covered, and you will be forced back to multiple daily injections. The supposed reason was cost-savings, but consider this: there are only an estimated 200 adult Medicaid recipients in Arizona on insulin pumps. According the Arizona Legislative Budget Office and Medicaid, the cost to the state of Arizona to continue providing these 200 adults with insulin pumps and supplies is an estimated $105,000 per year. (Meanwhile, the Arizona state budget recently passed by the Senate included $1 million in Medicaid coverage for chiropractic services – the only such amendment it allowed through.)


People with diabetes know that if you consider the cost of poorly managed diabetes, this is an extremely unwise economic decision: uncontrolled high blood glucose can lead to complications including blindness, amputations, stroke, and kidney failure (among others!). And severe low blood sugar – hypoglycemia – can land you in the emergency room within hours, if not minutes.


Exactly how unwise is this decision? Well, according to a 2011 study published in The American Journal of Managed Care (that looked at more than a half a million people with Type 2 diabetes), a low blood sugar that resulted in someone getting admitted to the hospital cost an average of $17,564. If you do the math, this means that if six (6) diabetic Medicaid recipients in the state of Arizona were to be admitted to the hospital because of a low blood sugar in a single year, the cost would exceed a year’s worth of insulin pumps and supplies for every adult Medicaid recipient in Arizona currently on an insulin pump.



Let me rephrase this:


-Arizona could either spend $105,000 per year to provide insulin pumps to all of its affected Medicaid recipients, or

-Arizona could cover the cost for SIX of those recipients to be admitted to the hospital because of low blood sugar, a possibility that is greatly increased in people who do not have the tools necessary to properly manage their diabetes


Which would you choose?


As noted, the Arizona House is currently considering an amendment to the budget that would reinstate coverage for insulin pumps for qualified Medicaid recipients. We need to help encourage them to make this happen.


Regardless of whether you live in Arizona, please consider tweeting this post – or simply “@AZHouseGOP – please support #Medicaid insulin pump coverage!”– to the people below. If you’re up for it, an email would be great, too. And DO IT NOW! It’s Wednesday morning at the moment, and this may be decided in a matter of a day or two. Also, if you know anyone who lives in Arizona who cares about such things, please pass this along.


Arizona moderate Republican representatives who hold the most sway on this issue:




Arizona journalists who might cover this issue:


@JimSmall @TomSprattPHX @JeremyDuda @MuckRack @HankDeanLight @Dennis_Welch 



Further contact info (for those of you who prefer emailing or calling):


Andy Tobin (speaker of the AZ house):


Rep. Frank Pratt: fpratt@azleg.gov

Rep. Jeff Dial, jdial@azleg.gov

Rep. Doris Goodale,dgoodale@azleg.gov

Rep. Ethan Orr, eorr@azleg.gov


Jim Small                                                                   

Arizona News Service Editor





Tom Spratt

Managing Editor






Jeremy Duda

Governor’s Office Reporter





Hank Stephenson





Angela Gonzales’s Muck Rack portfolio

Arizona Business Journal Senior Reporter



Dennis Welch

ABC TV Phoenix Affiliate




Additional background info on what insulin pumps are and why they’re important:


-Insulin pumps are beeper-sized devices that deliver insulin, which people with diabetes depend on in order to stay alive. They allow much better and more nuanced glucose control than multiple daily injections, and are an important – and cost-effective — component of diabetes management for many people with the disease. Here’s a photo of what they look like (for more information on why pump therapy is important, please ask in the comment section – anyone on a pump would be more than happy to tell you!):




-Arizona and Alabama are the only two states that don’t provide insulin pump coverage to people on Medicaid.


-In fact, every major health plan in Arizona (and elsewhere in the country) provides coverage for insulin pumps for qualified patients. We in the diabetes community do not believe that Arizona’s poor diabetics – who are disproportionally affected by diabetic complications to begin with – should not have access to the same important treatment option.


-Right now, Arizona covers pumps for qualified Medicaid recipients under 21 years old. But when they turn 21, they must go back on multiple daily injections. This would be the equivalent of spending your first 21 years with access to a cell phone, and then being forced to go back to only communicating via US mail. Do you think that might have a negative impact on your daily life? How about if mistakes caused by the postal service could actually kill you?


Many thanks for taking the time to read this and take action. And if you’re a legislator in Arizona, thank you for considering the needs of Arizona’s Medicaid recipients with diabetes. This is a really important issue and we appreciate your support. 

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Mike Anderson
8 years ago

2 Tweets sent to AZ SEN GOP and 1 sent to Media Tues AM 4/1. RT to  #DOC

8 years ago

Thanks, guys! And Ann, you make a good point: anyone interested in advocacy should definitely follow Kelly Close and the Close Concerns/Diatribe team. They are amazing. 

Ann B.
8 years ago

Don’t forget that Kelly Close brought to light the problem, last fall, for Oregon’s medicaid patients who were going to looose coverage for test strips.  Thanks to Diatribe and a few other people’s efforts there has been a reasonable agreement on test strips… this time! 


This should be everyone’s concern, as private insurers are watching carefully what medicaid and CMS mandate.

Mike Anderson
8 years ago

Just sent my Tweet to the House GOP twitter addresses. Thanks for spreading the word, Catherine!

Scott K. Johnson
8 years ago

Thanks for spreading the word about this, Catherine! 

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