American Diabetes Association® Disappointed by Changes to Essential Health Benefits that Put People with Diabetes at Risk


Michelle Kirkwood

April 11, 2018

New 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.”

About the American Diabetes Association

Nearly half of American adults have diabetes or prediabetes; more than 30 million adults and children have diabetes; and every 21 seconds, another individual is diagnosed with diabetes in the U.S. Founded in 1940, the American Diabetes Association (ADA) is the nation’s leading voluntary health organization whose mission is to prevent and cure diabetes, and to improve the lives of all people affected by diabetes. The ADA drives discovery by funding research to treat, manage and prevent all types of diabetes, as well as to search for cures; raises voice to the urgency of the diabetes epidemic; and works to safeguard policies and programs that protect people with diabetes. In addition, the ADA supports people living with diabetes, those at risk of developing diabetes, and the health care professionals who serve them through information and programs that can improve health outcomes and quality of life. For more information, please call the ADA at 1-800-DIABETES (1-800-342-2383) or visit Information from both of these sources is available in English and Spanish. Find us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn)