STATE LEGISLATIVE DIABETES & OBESITY

The Problem – Many Americans struggle to afford the medications they need to manage chronic conditions and maintain their health. Access to affordable prescription drugs remains limited, especially in underserved communities where resources are stretched thin. Without adequate support, individuals may be forced to skip doses or forgo treatment entirely, exacerbating health disparities.

The Solution – Kentucky offers a solution to this issue by partnering with community organizations to help eligible individuals access reduced-cost prescription medications through the Kentucky Prescription Assistance Program (KPAP). KPAP helps patients navigate through existing discounted drug programs offered by manufacturers, retailers, and other sponsors. By leveraging existing community networks such as county health departments, hospitals, food pantries, and faith-based organizations, KPAP can substantially expand its reach without duplicating efforts or significantly increasing overhead. The program helps over 4,800 Kentuckians secure $47 million in free and reduced-cost medications in just one year – making it a national model for cost-effective prescription assistance.

Sample Legislation: The Kentucky Prescription Assistance Program was created through a line-item in Kentucky’s biannual budget bill. Even though there is no sample legislation, the example provides a successful model that can be replicated in other states.

The Problem – Diabetes management is a significant challenge for many low-income individuals, particularly those relying on Medicaid for healthcare. Continuous glucose monitors (CGMs), which are vital for managing blood glucose levels, are often not covered under Medicaid in many states, leaving patients without access to a crucial tool. Without CGMs, patients are more likely to experience complications from poorly controlled diabetes, leading to costly medical interventions and long-term health consequences. 

The Solution – Arkansas has addressed this gap by passing legislation that mandates Medicaid coverage for CGMs, ensuring that low-income residents have access to this essential diabetes management tool. CGMs help patients maintain better control over their blood glucose levels, reducing the likelihood of complications and lowering healthcare costs. Studies show that the adoption of CGMs can save Medicaid an estimated $4,000 per patient over nine months compared to patients who do not use the technology. By including CGMs in Medicaid coverage, states can protect their most vulnerable residents, improve diabetes management, and reduce avoidable healthcare expenses.