Friday Notes

Laddie_Head SquareYesterday was a busy diabetes day. In addition to just having diabetes (and believe me, that’s enough!), I attended an advocacy training program sponsored by the American Diabetes Association (ADA) and there was a vote by an FDA Advisory Committee regarding the Dexcom G5.

Number #1: My DiabetesNothing momentous to say about my diabetes except that yep, I’ve still got it. I had a big unexpected BG spike after a restaurant salad lunch. Maybe there was hidden sugar in the salad dressing. Maybe my glass of wine decided to be a problem. Maybe it was the mid-morning peanut snack dosed with an extended bolus. Maybe it was because it was 90+ degrees outside with off-the-chart humidity even though I was comfortable inside with air conditioning. Maybe it was because it was Thursday. This is the sort of stuff that makes it a miracle that those of us dealing with Type 1 even have a modicum of sanity left in our lives.

Number #2: ADA Advocacy Training:  I attended a late afternoon Advocacy Training seminar sponsored by the American Diabetes Association. I found it to be very empowering and in a moment of bravado, I signed up to be available for in-person office visits to my congressional representatives. I am a confident advocate when writing, but speaking and putting myself “out there” border on terrifying.

The ADA has a good app for advocacy and I suggest that you check it out. It provides information on national and state advocacy priorities and links to easily become involved in ADA advocacy. Search for “Diabetes Advocacy” in the app store.IMG_0298

Because Scott Johnson was the reason that I knew about this seminar, I can’t say that it was a surprise to run into him by the Diet Coke cooler. But it’s always a pleasure to see Scott.IMG_0295

Number #3: FDA and Dexcom G5:  I was pleased to receive an email from Bennet Dunlap of DPAC sharing news from yesterday’s FDA Advisory Committee meeting on Dexcom G5 labeling. The panel voted 8-2 to recommend approval of a G5 labeling change to allow insulin dosing without a confirmatory BG meter test. The FDA will have to make the final approval, but it is likely that the advisory committee’s recommendation will be accepted. This change should help justify Medicare coverage for CGM’s as well as expand the use of CGM to more patient populations.IMG_0932

That’s it for today. Have a good weekend!

 

We Regret to Inform You

Laddie_Head SquareMy health insurance life is imploding and exploding. I can’t tell the difference between what I know and what I don’t know. What I heard last week isn’t true this week and might change again next week. In January I wrote about dreading Medicare. Today I think it might be the best thing that could happen to me.

On June 23 Blue Cross Blue Shield of Minnesota (BCBS) announced that it will discontinue full-service plans in the individual health insurance market beginning in 2017. This follows the exit or reduction in offerings by other companies in previous years. Minnesota was one of the states that created its own insurance exchange in 2014 after the implementation of the Affordable Care Act (ACA) and the results have been devastating for many of the 6% of citizens seeking individual insurance in the state. (The individual market covers people who do not have access to employer-based coverage and are not eligible for Medicaid or other publicBCBS Blexit programs.)

BCBS of MN is the only company so far to announce its exit from the 2017 individual market. Unfortunately it is the largest insurer in the market and its departure will affect 103,000 of the approximately 300,000 Minnesotans who purchase individual insurance. The recent announcement by BCBS follows a premium hike of over 50% in 2016. This increase was justified by the carrier’s reported loss of $265 million dollars in the 2015 individual market.

My 2016 monthly premium was 61% higher than in 2015 and was accompanied by a slightly higher deductible. If BCBS is continuing to experience unsustainable losses with the huge premiums that I am paying, my fear is that no company will be able to survive longterm in this market. Unfortunately as rates soar, many young and/or healthy individuals are choosing or being forced to go without insurance. The downward spiral of an unsustainable market is intensified as the insured population gets older and sicker and costs skyrocket.

I have no idea what the landscape for the individual insurance market in Minnesota will look like next year. It seems questionable that the remaining players can absorb the 103,000 people stranded by BCBS. Will other insurers pull out? Will exorbitant premiums, high deductibles, limited networks, and poor coverage be the norm? What will be the effects of the presidential election with one candidate vowing to repeal the ACA?

All I know is that I received a letter that says:

“We regret to inform you that at the end of this year, Blue Cross and Blue Shield of Minnesota will be discontinuing all individual and family insurance plans sold to members in Minnesota directly, through an agent or broker, or on MNsure. As a result, you will not be able to renew your current plan or select another Blue Cross plan for coverage in 2017.”

I personally only have to deal with this for three months in 2017 and will transition to Medicare on April 1. I know others who do not have this option. Some of them have Type 1 diabetes and the outlook is bleak.

Yes, Medicare is definitely starting to look pretty good.

*****   Relevant Articles   *****

http://www.startribune.com/blue-cross-eyes-major-exit-from-individual-market/384303131/

http://www.startribune.com/regulators-approve-premium-jumps-averaging-as-much-as-49-percent-in-minnesota/330275391/