Skyrocketing health care costs leave an increasing number of Americans uninsured or with less meaningful coverage than they need and deserve—especially the 24 million Americans with diabetes.1 The results of a recent survey found that 72 million, or 41 percent, of nonelderly adults have accumulated medical debt or experienced difficulty paying medical bills in the past year – 61 percent of whom had insurance.2 Any medical event, like the diagnosis of diabetes, could place a person at risk for potentially devastating financial costs, even if they have health insurance.

The prevalence of diabetes more than doubled over two decades from 1986 to 2006,3 making diabetes the fifth deadliest disease in the nation.4 And its prevalence is expected to continue to grow in the coming years, as risk factors such as obesity, high cholesterol, and high blood pressure continue to rise.

Families with a member who has diabetes not only shoulder the emotional burden of caring for a sick loved one, but also the economic burden of the growing cost for treatment. Diabetes cost the United States $174 billion in 2007, an increase of $8 billion per year over the last 5 years. The total cost is a combination of $116 billion in direct costs of treatment and $58.3 billion in indirect costs of lost productivity.5

Americans diagnosed with diabetes, whether insured or not, face significant and sometimes devastating hurdles to receiving timely, affordable treatment in our health care system. Health insurance reform seeks to eliminate these hurdles to ensure that people with diabetes, along with all other Americans, get the quality, affordable health care they deserve.

HEALTH INSURANCE COSTS FOR PEOPLE WITH DIABETES
Problem: People with diabetes who have insurance are often exposed to high and potentially ruinous out-of-pocket health care costs.

With each passing year, families face increasing deductibles, copayments, and other cost-sharing requirements, compelling them to make difficult decisions in order to make ends meet. People affected by diabetes are particularly aware of these rising costs, as they have medical expenditures more than twice as high as those who do not have diabetes, with total annual health care costs for a person with diabetes topping $11,744 in 2007.6

Individuals with diabetes are at an increased risk for stroke, heart disease, blindness, amputation and kidney failure, making regular physician visits a necessity to properly manage the disease. Prescription medications including vials of insulin and/or oral medications are also a necessity. And patients with diabetes at home must monitor their blood sugar levels frequently using blood glucose monitors and test strips.

Physicians recommend that people with diabetes test their blood sugar levels two to six times a day. Because most test strips are monitor-specific, a box of 100 test strips can cost up to $60.7 Additionally, the price of a vial of insulin can range from $30 to $70, mainly because generic brands are not manufactured in the US. Many patients find that their insurance does not adequately cover these costs, making treatment unaffordable and inaccessible.8

While devastatingly high out-of-pocket costs are experienced in households across the nation, households with a family member suffering from diabetes find increasing out-of-pocket costs especially burdensome. A quarter of households that have someone with diabetes have health care costs totaling 10 percent or more of household income, and eight percent have costs that exceed 20 percent of household income.9 As a result of such high costs, one in six individuals with diabetes report avoiding or delaying needed medical care because of cost.10

Cathy (33) in Pennsylvania was happy with her husband’s job-based coverage until the employer decided to drop coverage for all brand name prescriptions. No generic equivalent for insulin exists. Cathy applied to the manufacturer for free insulin but was turned down because she had health insurance and her husband, a truck driver earning about $40,000 per year, made too much money. At one point, the couple considered disenrolling from coverage so Cathy could qualify for free insulin.11

Health Insurance Reform Solution: Ensure adequate coverage and limit out-of-pocket costs.

Individuals with diabetes are frequently forced to make decisions based on their finances and not on what is best for their health. Health insurance reform will eliminate annual or lifetime limits on benefits and set a cap on what families pay out of pocket annually for health care. It will also promote transparency and simplicity in comparing plan benefits and costs, so that people can choose the plan that works best for them.

HEALTH INSURANCE CHOICES FOR PEOPLE WITH DIABETES
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