People with T1D need access to affordable health insurance that covers the care necessary to treat their diabetes. To survive, they rely on daily supplies of insulin and the tools required to dose this life-saving medication.
JDRF has joined with more than 70 organizations that advocate on behalf of people with chronic, serious, and life-threatening diseases to educate the incoming administration and Congress on the unique health insurance needs of our community. In December 2016, this group sent a letter to then President-elect Trump and Congressional leadership explaining the importance of policies protecting those with pre-existing conditions and allowing young adults up to age 26 to remain on their parents’ health plan.
JDRF has released a set of healthcare principles and will be working with a variety of stakeholders to advocate that these principles are considered in any healthcare reform that may take place in 2017.
- Preserve protections for those with pre-existing conditions so they have access to complex health insurance at rates similar to people without such conditions. The ACA includes provisions to ensure that people with preexisting conditions—like the 1.25 million Americans who live with T1D—cannot be denied coverage, charged significantly higher premiums or have their benefits curtailed by insurance. This is crucial for people with T1D who need health insurance coverage to access the drugs and devices that keep them alive every day.
- Allow young adults to stay on their parents’ insurance until the age of 26. Current health law allows young adults to join or remain on their parents’ health insurance until the age of 26. Remaining on a parent’s plan is crucial to children and young adults with diabetes who have much greater healthcare expenditures, approximately 2.3 times higher, than their peers without diabetes. The provision, which ensures these young people have consistent and affordable access to supplies and medications necessary to manage their disease, continues to have broad bipartisan support.
- Prohibit insurance companies from setting annual and lifetime dollar limits for essential health benefits (EHBs). Before passage of the ACA, insurance companies were able to set dollar limits—either annually or for the entire enrollment period—on spending for an individual’s covered benefits. For people with chronic illness, annual and lifetime caps on EHBs can present a wide array of problems and worry. Consider insulin, a prescription medication, to which daily access is essential for people with T1D to stay alive.
- Close the coverage gap in most Medicare prescription drug plans by 2020. These plans have a temporary coverage gap for drugs, or “donut hole”, during which people with T1D may not be able to afford their prescription medications. The current healthcare law reduces these expenditures for approximately 200,000 to 300,000 people with T1D enrolled in Medicare.