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Both Medicaid and Medicare play a major role in, and bear a huge part of the financial burden of America’s diabetes epidemic.

Under the current Medicaid system, states vary in benefit structures, causing many Americans who depend on Medicaid to cover their diabetes supplies and services to have adequate access to the services and tools they need to properly monitor and manage their disease. This results in a dramatic increase in the risk of diabetes-related complications such as blindness, kidney failure, and amputations.

Many recipients rely on Medicare for their diabetes supplies and services and many services are covered under Medicare. One out of every four Medicare dollars is spent on diabetes. The Medicare Modernization Act allows those at risk for diabetes to receive up to two diabetes screenings per year, in addition to a one-time “Welcome to Medicare” physical.

Medicaid

Medicaid is a government-sponsored health insurance program for low-income populations.  As low-income individuals are disproportionately affected by diabetes, we are very concerned with proposals that would cut or reduce benefits and eligibility, as well as efforts to introduce or increase co-payments and monthly premiums.

Such proposals have a negative impact on enrollees with diabetes.  For instance, proposals to eliminate coverage for durable medical equipment would mean enrollees with diabetes would not have access to supplies critical to diabetes management and the prevention of serious complications, including heart disease, stroke, kidney disease, blindness and amputations.

While cutting care to people with diabetes may provide short-term savings, it will ultimately result in increased spending on emergency room visits, hospitalizations, treatment of serious complications and overall healthcare system expenditures.

We urge legislators to oppose cuts to Medicaid that would result in benefit reductions, restrictions on eligibility and caps on funding. Such cuts reduce the adequacy of Medicaid coverage for people with diabetes who rely on this vital safety net for their health care needs. 

Medicare

We continue to monitor legislative and administrative proposals that affect Medicare beneficiaries with diabetes. This includes policy affecting Part D.

Since the Medicare Modernization Act (MMA) went into effect in January 2006, we have closely followed implementation of the prescription drug benefit offered under Medicare Part D. Many bills have been introduced in the Senate and House of Representatives that seek statutory change to varying aspects of MMA. We continue to monitor such legislation.

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Health Insurance Options for People Age 65 and Above

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