Moving Mountains is a non-partisan, Grand County group of citizens dealing with issues that affect all of us. Here’s Moving Mountain’s take on how the proposed AHCA will impact people with diabetes in Grand County. The non- partisan Congressional Budget Office (CBO) has reviewed the AHCA laws (both Senate and House) and based on their findings 22 million people will lose their health insurance.

Diabetes is a chronic disease for which there is no cure, and is considered a pre-existing condition. In Grand County, approximately 624 individuals have diabetes, according to the Colorado Health Department, or approximately 1 of 10 people in our County. Insulin is commonly used to treat diabetes and the consequences of untreated or inadequately treated diabetes are severe. Diabetes is a leading cause of blindness, kidney failure, amputation, and heart attacks. Medical costs exceed twice those of people without diabetes. The latest data show the total cost of care per diabetes patient was over $12,000 a year. It is the 8th leading cause of death in Colorado.

The out of pocket expenses for people with diabetes have soared in recent years to the point that people are not able to afford the needed insulin dose, or the blood sugar strips they use to decide the proper dose. The 3 pharmaceutical companies that produce insulin have jointly tripled the cost of insulin over the past 11 years. Doctors spend more time trying to help their patients determine how to afford their treatment than on educating them about the disease. The AHCA Law will hurt people with diabetes in Grand County by ignoring the pharmaceutical companies hold on our drug pricing, which is currently 8x that of other countries. In Canada, the price of a vial of insulin is $35-
$40 while in Grand County it is $280- 330 a vial (Safeway, City Market and Kremmling Mercentile). A person with type 1 diabetes uses 2-3 vials a month, while a person with type 2 diabetes who
is resistant to insulin requires 6 or more vials a month. Blood sugar monitoring strips run another $100 a month

Going back to letting insurance companies exclude those with pre- existing conditions or charging them more will be devastating for people with diabetes. High-risk pools for those with pre-existing conditions have been tried in Colorado and resulted in premiums 150% higher than the market rate and deductibles as high as $10,000. Even then, coverage was limited. The Senate version of the ACHA gives money in block grants to states, that may individually decide whether to insure those with pre-existing conditions, and also to decrease essential benefits, likely eliminating prescription drug coverage, making insulin an out of pocket expense. Under the AHCA, the CBO predicted that people with diabetes may decide that insurance coverage is not worth the expense of premiums, co-pays, and deductibles. This failure of affordability returns us to “care by emergency room”, a very expensive way to treat diabetes and a cost we all shoulder. Also, older, lower income people will receive less financial assistance under the AHCA than they received under ACA.

Unfortunately, the $800 billion cut in Medicaid coverage and severely decreased spending proposed in the ACHA law will be stunningly severe. According to the CBO, by 2018 there will be 15 more million uninsured than currently under the ACA. Children in Grand County with diabetes may depend on Medicaid for their healthcare. It is more humane and better economics to give people with diabetes the care and affordable insulin that they need to treat their diabetes. We all pay for people with diabetes who are not given access to good healthcare.

Deb Thomas-Dobersen, Certified
Educator, writing for
Moving Mountains

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