While estimates suggest that hundreds of millions of Americans may contract the coronavirus, the complications experienced by those infected will vary widely. The whole point of “flattening the curve” is to ensure that those who are most in need of medical resources — the elderly and those with underlying health conditions — can receive medical attention when they need it.
The over 34 million Americans living with diabetes make up a significant part of this group, and we need Congress and the states to provide urgent help to blunt the potentially devastating impact on our community.
A person living with diabetes must be extra vigilant about common infections — not to mention novel global pandemics — because diabetes can compromise the immune and metabolic systems that help most people fight off viruses. Even when well-managed, people living with diabetes are at higher risk of dangerous complications from seasonal flu. In recent years, Americans with diabetes have accounted for nearly one-third of all reported adult flu hospitalizations. Given official estimates that COVID-19 is ten times as lethal as the seasonal flu, we can’t afford to ignore the tremendous risk that those of us living with diabetes face during this historic health crisis.
That’s why leaders in Congress and state legislatures must intervene now to ensure that the 10 percent of the population who live with diabetes are protected from infection and can manage their health through the coronavirus pandemic.
Congress can start by passing two reforms as part of its next rescue package: First, Congress should require that people with diabetes be able to receive insulin with no co-pay for the duration of the emergency. With short-term unemployment expected to spike up to 20 percent, many Americans with diabetes may find themselves without a job. Allowing fellow citizens to go without insulin during this crisis would be a national disgrace and would inevitably worsen the health toll of the current COVID-19 threat.
Second, Congress should eliminate technical barriers that undermine efforts to keep people living with diabetes healthy. For people with diabetes who require a continuous glucose monitor, for example, there is a Medicare requirement that they must see their doctor in-person every six months to renew their monitor. We should not have to put ourselves in harm’s way to get the care we need. During a global pandemic, those living with diabetes should be encouraged to stay far away from doctor’s offices and hospitals whenever possible. Telehealth is a good option, but only if Congress waives the in-person visit requirement to keep us safe at home.
At the state level, legislators and regulators don’t have to wait for Congress to act. States can mandate free co-pays for insulin with or without congressional action. Colorado, Illinois, and New Mexico have already capped out of pocket insulin costs, some as low as $25 per month, and dozens of other states are considering similar proposals. For the duration of the crisis, those caps should be lowered to zero and implemented across the country.
States should also offer automatic Medicaid enrollment to all those who lose their jobs in this national emergency. Such a reform would offer a medical safety net to millions of Americans, not just those with chronic health conditions, including the more than 30 million Americans with diabetes.
Before the entire country was in the midst of public health crisis, millions of its citizens were already dealing with private health crises of their own. As the entire country prepares to defeat COVID-19, we can’t forget the millions among us who are most in danger. It’s not just the elderly, and it’s not just those in hospitals. It’s our mothers, fathers, brothers, sisters, neighbors, and friends who live with diabetes, one of the most common chronic health conditions and one that deserves to be addressed immediately by those who can make a difference in millions of lives.
I urge our leaders in Congress and state legislatures to take the necessary steps to protect our country’s most vulnerable citizens.
Tracey D. Brown, who lives with type 2 diabetes, is Chief Executive Officer of the American Diabetes Association (ADA), the nation’s largest voluntary health organization and a global authority on diabetes.