When Americans cast their ballots on or before Nov. 6, there’s a lot at stake for the diabetes community.
We’re not only talking healthcare and how that might be impacted by who’s chosen to be in the White House. (Sure, that’s the biggie and what most eyes are on). But it’s important not to lose sight of all the Congressional elections happening throughout the country. Hundreds of elections are slated between the Senate and House of Representatives, and those outcomes have a great impact on how the country will be run for at least the next two years until the 2014 midterms.
For us in the D-community, the results of those races may influence how money is earmarked for diabetes research and prevention, the attention that all types of diabetes receive legislatively and politically, and on a very practical level, could impact how people with diabetes get their supplies and medications in coming years.
Welcome to crunch time of Election Season 2012, D-peeps!
No worries: we’re not about to go promoting any particular party, politician or even way of thinking. Our country and community is very diverse, and that’s a good thing. But we do want to highlight some of the specific diabetes issues that come to light in this election season:
The Diabetes Caucuses
As happens every two years, all 435 seats on the U.S. House of Representatives are up for grabs; a total of 42 representatives are not seeking re-election and 12 incumbents lost in primaries earlier this year. A third of the 100 Senate seats are also open, and that means the country could see some significant shifts in who’s sitting in these elected spots to sponsor diabetes-related legislation. Not to mention those who are on the diabetes caucuses, which serve as non-binding educational commiittees working to get accurate information to the rest of Congress.
A changing lineup within the Congressional Diabetes Caucus and the Senate Diabetes Caucus could broadly impact issues that legislators might be taking up anytime soon.
Our review and cross-reference of the caucus members and those seats on the ballot shows that 12 of the 39 Senate caucus seats could change hands. For the House, 33 of the 230 caucus members specifically aren’t returning because of retirements or lost primary elections.
Key staffers on both the House and Senate side say there’s no specific plan in place about how the election results might influence the diabetes caucus business and priorities. That will likely only become apparent when legislators report back to work Nov. 13.
Sen. Jeanne Shaheen, the Democrat from New Hampshire who leads the Senate Diabetes Caucus and whose granddaughter lives with type 1, told the ‘Mine that she’s committed to ensuring diabetes is a priority for legislation no matter what happens in the elections.
Some states have their own D-Caucus
“While we have made progress in furthering diabetes research, there is more we can do to invest in prevention, find innovative treatments and hopefully discover a cure. As the co-chair of the Senate Diabetes Caucus, I look forward to continuing the fight against this debilitating disease.”
Kind of a canned statement, to be sure.
But even though she’s a grandma of someone with type 1, the fact is Shaheen is bound by politics and is probably very careful in what she can say. It is a reassuring, though, that she’s leading the Senate D-Caucus with Republican Sen. Susan Collins and neither of those two are going anywhere this election season as they’re not up for re-election until 2014.
D-Community Legislation
Some specific legislation is already on the table that is focused on the D-Community: the Medicare Diabetes Prevention Act of 2012, the National Diabetes Clinical Care Commission Act, and of course renewing the Special Diabetes Program (SDP) that expires next year. We also can’t look past the regular budget spending issues when it comes to diabetes research funding, and how that could be impacted by votes on National Institute of Health (NIH) budgets and other healthcare-oriented votes.
Knowing how your candidates view these issues and plan to vote is an important aspect for us PWDs to think about.
A big push by both the JDRF and American Diabetes Association is the SDP, which funds NIH type 1 research and also funds treatment, education and prevention programs for the American Indian populations affected by type 2. Without the renewal, we’d see a 35% loss of $150 million in diabetes research money.
In the spring, a bipartisan contingent of 72 senators and 278 representatives signed letters in support of this funding. That may be a place for PWDs to start in looking at their own election choices, regarding who has or hasn’t supported diabetes funding in the past.
Cynthia Rice, the JDRF’s VP of Government Relations, said PWDs interacting with candidates or Congress members should ask: “Do you support diabetes research and what have you done?”
The ADA’s associate director of communications, Lauren Gleason, wasn’t able to comment because of the organization’s stance as an “apolitical” organization. We were a little disappointed by that response. The ADA expects to finalize its 2013 legislative priorities in November, but that doesn’t do anything to address the issues voters might want to think about when casting ballots.
Once the election happens, the plan will likely be to attach the SDP renewal to a “must pass” piece of legislation that will be voted on in the lame duck session. That means current elected officials will vote on it before the new guys come into office. Nothing’s official, but some speculate it could be a Medicare-focused bill.
Presidential Buzz
Sadly, we’re not talking about the Kid President and pronouncing the word “diabetes.” That would be a whole lot easier, now wouldn’t it? No, it’s time to be a little more serious…
So, U.S. President Barack Obama (a Democrat) wants to remain in the White House for another four years. But his opponent Mitt Romney, the Republican governor of Massachusetts, thinks he’s better suited for the job. And they disagree on a whole bunch of things.
We got a peak into their healthcare mindset during the first debate on Oct. 4, when Obama actually mentioned diabetes! He pointed to diabetes as a condition that costs a lot of money, and stands as an example of how the healthcare reform would streamline medicine by getting all doctors together in one room to manage the PWD’s care and test. (Did someone say Patient Centered Medical Home?) With the second presidential debate happening tonight, I wonder how healthcare might come up again…
Interestingly (maybe for the first time in history?), healthcare happens to be one of the hottest debated issues in the presidential race!
“Freaking Out” About Healthcare Reform?
An analysis released Oct. 10 by ScienceDaily found that likely U.S. voters ranked “health care and Medicare” the second most 
important issues in deciding on the president (the first was economy).
For most, the contention comes down to the Affordable Care Act, a.k.a. Obamacare, the president’s big push and a defining aspect of his presidency to date.
We know that a number of fellow PWDs take the issue very personally. have impassioned views on this topic, and even fear for their future. For example, fellow type 1 Sarah Knotts, who’s 28 and from South Carolina and blogs over at Sugabetic, is trying to balance what she sees as the broad need for universal healthcare coverage with the ability of individuals to afford their own insurance coverage:
“While I am SO glad that uninsured people can now have the insurance ‘safety net,’ I’m completely and utterly infuriated at what it’s done to my family,” she wrote in a recent post titled Conflicted, describing how her husband’s employer has decided to change insurance plans to comply with aspects of the reform even though though the law doesn’t require those changes by any employer. “I’m freaking out about how I’m going to pay for my supplies next year until my high deductible is met.”
Sarah also says she doesn’t think the entire ACA should be repealed (as Romney has vowed to do), but she does hope something could be done differently to let people keep the existing insurance coverage they have without basically giving employers and incentive to cut costs in order to comply with the new law.
Wooing Mrs. Obama
To type 1 New Yorker Amy Jordan, founder of the youth outreach Sweet Enuff Movement that supports kids affected by or at-risk for diabetes and childhood obesity, this election season is important for the Diabetes Community. Amy’s initiative works to help youth prevent D-complications as a result of education or resource limitations, and it combines hip-hop dance fitness with health and life coaching to create “a new culture of health that’s fun, educational and empowering.”
Diabetes Advocate Amy Jordan & Michelle Obama
(Diagnosed at age 4 in 1972, Amy was a professional dancer herself before developing some diabetes eye complications, and she founded the company based on her experiences with diabetes.)
As an advocate Amy got the First Lady’s attention in late 2011, as a result of Mrs. Obama’s public effort to fight childhood obesity. Amy says she was able to introduce Mrs. Obama to Sweet Enuff and the mission of preventing diabetes-related complications through arts in education. Though the two didn’t go into depth in discussing diabetes, Amy knows Mrs. Obama is deeply and sincerely committed to reversing the diabetes and epidemics shortening lives of youth. Ensuring adequate health care coverage for youth and those with diabetes is important to Amy and is a key motivator in how she’ll cast her votes.
“I am no expert on Obamacare, but I do believe he wants to implement a preventative approach to diabetes care and this is crucial for a healthy life with diabetes,” Amy said. “If the government does not implement a proactive support system for people with diabetes or at risk for diabetes, the cost will be immeasurable. Not only for people with diabetes, but everyone who pays taxes. Only the drug companies will win in this scenario.”
Taking Your Own Stand…
Finally, don’t forget about the state level. Eleven governor spots are open. And a total 86 of the 99 legislative chambers will hold state legislative elections this year, with 66% of the State Senate seats up for grabs and 87% of the State House seats up for re-election.
Those are the places more local where many state health programs and insurance rules, not to mention budget-setting, happens. The Medicare population is particularly at issue on the state level, as each individual locale sets its own rules based on regional budgets.
Personally, I’ve been inside the local and Washington D.C. offices of my congressional leaders and had conversations with their staffers and with some of my legislators personally. What they’ve said, how they’ve shown their support or not shown their support for diabetes issues (like research involving stem cells) has helped shape my voting choices.
Of course diabetes issues aren’t the only thing influencing my voting trends. But it is a priority issue for me, and so I try to do my homework and ask a lot of questions.
In short, there are many choices that will impact the Diabetes Community and shape our country moving forward. It’s up to each one of us to do our part in knowing who we are voting for and for which they stand.
This is what I posted over @ Sugabetic’s blog:
Hmmm … the excise tax doesn’t take effect until 2018. I can see where the company would say, they are moving to the higher co-pay and deductible plan to “prepare” and so employees wouldn’t be “shocked” by a change in 2018, but still … could their explanation have any between the lines interpretation?
FWIW, my own health plan has seen co-pay and deductible increases (or coverage decreases) every year for over 20 years.
A couple of other points. There is a provision in the ACA that says if the health insurance plan for Congress and Federal employees increases by 55% between the start of the act and 2018, then the threshold for taxing “Cadillac” plans increases as well. After some recent reading on how healthcare is likely to keep growing at a higher rate than inflation, I wouldn’t be surprised to see the threshold increased to better meet “reality”. Also keep in mind the 40% tax is on the amount ABOVE the threshold. Therefore, if a family plan is $28,500 and the threshold is $27,500, the tax would be 40% of $1000, or $400.
On the flip side, certain plans in certain states are likely to see some pretty significant taxation amounts by the time 2018 rolls around. UGH!
I suppose some non-PWD’s are blissfully unaware that health care coverage has declined over the years.
I have no interest in patient-centered improvements. What would most help my T1 are affordable pump and CGM and yet my DME copay has progressively increased from 20% to 30% and now 50%.
Healthcare has been a runaway freight train for years in this country and while there are some important parts in ObamaCare, one of the most important pieces that is effectively absent is limiting compensatory damages. But, why bite the hand that feeds you. Most socialized medicine in EU provides for limits on compensatory damages.
The Supreme Court weased out on their ruling, effectively subjugating all TAX PAYING americans to be taxed at will in order to pay for this plan.
If anyone thinks the world will get better is an Ostrich.
Every time someone mentions limiting compensatory damages, it’s a little distressing to me. The only arena where an individual and a corporation can fight on a level playing field is civil court.
Since the Liebeck v. McDonald’s case (which Lieback won), people have been screaming for tort reform without understanding one salient fact: limiting compensatory damages actually takes power away from the people. Before many states adopted caps on compensation amounts, do you know who decided what damages would be in a civil injury case? A jury, made up of people like you and me. We now effectively have no way to make a company change dangerous policies short of criminal prosecution.
What few people know about the aforementioned case is that McDs had 700 complaints from people getting burned by coffee AND the punitive damages initially awarded by the jury (2.5 million) was two days PROFIT from coffee sales.
Now an individual suing for damages from a company is limited in their compensation no matter what a jury decides, though the cost for treating their injuries is not limited by a cap.
I’m guessing the biggest impact of the new laws is to give previously uninsured T1′s access to insulin and strips. As one already paying into the system, I may not see any bottom-line difference in my benefits/cost although it is nice to know I can’t ever be denied coverage for my pre-existing condition.
Btw, why do I need a doc to renew my scrips? It’s not like my T1 is going away. Every visit to my doc for scrip renewals is probably
billed to insurance in the hundreds of dollars, for what, the equivalent of a signature?
Sadly, the recent decision of Medi-Cal to limit the number of test strips per day to 5 sets a precedent for ACA to limit test strips–government insurance tends to focus or cost effectiveness and effectiveness of treatment-not necessarily the most innovative or best quality of life treatments. Pumps will become harder to get as will Flexpens. MDI wih vials and syringes are considered “good enough”….government involved in healthcare decisions is scary.
As a child, my father coached me from an early age that I could not be an artist, an entrepreneur, a small business owner… in short, he coached me I could NOT be ANYTHING I wanted to be.
The reason for this was simple. I was diabetic. And unless I worked for a big company, I would never be able to get coverage by myself.
Luckily I grew up being ‘okay’ with working for a big company, but that fear of a major complication setting in, and me being unable to work to maintain coverage is overwhelming. Most folks don’t understand that a company has no obligation to cover you if you can no longer work. Cobra only lasts so long. If you are disabled ‘enough’ to not be able to work, but not ‘enough’ to qualify for SS disability medical coverage, you are royally screwed.
Denying folks with pre-existing conditions coverage is evil. But you can’t have one without the other. You can’t say we’ll cover anyone with a pre-existing without having enough money to pay for it. And that ability to pay for it means everyone has to have coverage (or everyone would just wait for calamity to happen and then enroll).
I’m glad you are worried about the number of times you can test a day. Government is not taking away your flexpen or insulin pump or cgms. In fact, medicare COVERS CGMS RIGHT NOW. That is government – right now – covering it.
I can’t tell you how many times I met folks while receiving chemo that had RUN OUT OF INSURANCE. Do you know what it is like to receive life saving treatment in one arm while watching the guy next to you get denied? What do you say to that man? “I wanted to make sure I could test 6 times a day instead of 5!”
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