Washington, DC - Proposed rule from the U.S. Department of Health and Human Services jeopardizes coverage of life-saving care for people with diabetes 

Today, the American Diabetes Association (ADA) expresses disappointment with the Notice of Benefit and Payment Parameters for 2019, announced on April 9 by the U.S. Department of Health and Human Services (HHS), which moves forward with changes that weaken rules requiring certain health plans to cover a minimum set of “essential health benefits” (EHBs). The changes allow states and health insurers to scale back coverage of EHBs, which include prescription drugs, preventive services, chronic disease management, hospitalization, maternity, and newborn and pediatric care. This final rule allows states to redefine EHBs and/or give insurers flexibility to avoid covering benefits that are necessary for people with pre-existing conditions including diabetes.

On behalf of the more than 114 million Americans living with or at risk for diabetes, the ADA has advocated for years at the state and federal level for robust EHB coverage. When the proposed rule was released in November, the ADA’s professional members and advocacy leaders submitted comments and concerns telling HHS how harmful this change would be for people with diabetes. Despite this, HHS has finalized the proposal and will allow reduced benefit standards beginning in 2020.

“All people living with diabetes should have access to comprehensive health insurance that includes coverage for the care necessary to successfully manage their disease and avoid costly, and life-threatening, complications,” said ADA’s Senior Vice President of Government Affairs and Advocacy LaShawn McIver, MD, MPH. “The changes issued by HHS put Americans with diabetes at risk, and it is our mission to continue to advocate on their behalf. ADA is committed to continuing our advocacy work at the state level to maintain or improve, not reduce, coverage of essential health benefits for people with diabetes across the country.”