10% of adults diabetic
N.M.'s high afflication rate prompts Domenici legislation

By Kathy Helms
Diné Bureau

GALLUP — U.S. Sen. Pete Domenici has introduced bipartisan legislation which would ensure the medical needs of Native Americans and Hispanics who suffer from diabetes are being met.

Looking at the growing diabetes crisis in New Mexico and around the nation, Domenici teamed with Sen. Charles Schumer, D-N.Y., to offer the Diabetes Screening and Medicare Savings Act of 2007 (S.755).

The legislation would initiate a diabetes screening benefit within Medicaid that mandates coverage of treatment, supplies and education for those diagnosed with diabetes.

Such screening and subsequent care is not mandated under the existing Medicaid program. The bill also has a strong focus on preventive health care measures to help contain the alarming rise of diabetes in the United States.

As of 2004, the Centers for Disease Control estimated that about 170,000 adults in New Mexico suffer from diabetes nearly 10 percent of the state's population. In 2002, the American Diabetes Association estimated that national spending on diabetes care was $132 billion.

Diabetes affects nearly 21 million Americans. The number of adults diagnosed has increased by more than 60 percent since 1991 and is projected to more than double by 2050. It ranks as the sixth leading cause of death in America.

Domenici said that because diabetes is especially prevalent in low-income and certain ethnic populations, the bill makes sure that the needs of these populations, such as Native Americans and Hispanics are addressed.

The new bill builds on the estimated $1 billion that has been directed toward Indian diabetes prevention and treatment programs that Domenici helped craft within the 1997 Balanced Budget Act.

The result of that act was an agreement to finance Indian Health Service diabetes programs by providing annual mandatory funding specifically for diabetes prevention and treatment.

The program began with a mandatory $30 million annually for five years and has been expanded over the last 10 years to $150 million a year. This funding has been used widely in Indian Country, including among the Navajo Nation and pueblos in New Mexico.

Complications of diabetes can be prevented and the costs of this disease to our society can be contained," Domenici said. "Early detection and treatment is the key. We've learned a measure of that with the Indian diabetes program.

He said the increasing burden of diabetes and its complications are frightening, but much of this burden could be prevented with early detection.

"Methods for controlling diabetes and minimizing its impact on health and health care costs are well documented. Yet access to these services, including screening and early interventions, varies by state. Our bill will provide a uniform benefit within the Medicaid program, he said.

According to Sen. Schumer, the legislation is the first step toward stopping the diabetes epidemic in its tracks.

"By focusing on screening and prevention, this bill will lower the overall burden of cost on our health care system and create a healthier more productive society," he said.

"It is essential that we take a new approach toward diabetes care by focusing on early age prevention rather than spending more on costly end-of-life care," Schumer said.

The Schumer-Domenici bill would provide screening tests under Medicaid for high-risk adult enrollees and would ensure that states offer a comprehensive package of benefits needed to adequately manage diabetes care.

It would guarantee Medicaid coverage of diabetes services, including insulin, foot exams and diabetes education. The measure also stipulates that diabetes services for Medicaid patients would not be subject to cost-sharing requirements.

The bill also would improve coverage for prescription drugs, durable medical equipment, services related to pregnancy, vision care, podiatry services, education and self-management training, and nutrition services.

"Diabetes health care specialists say that many patients who are diagnosed with diabetes initially visit their doctor not for symptoms related to the diabetes, but because they are already suffering from the secondary complications," Domenici said.

"If diabetes complications are the first indication that you have diabetes, you are starting your fight at an incredible disadvantage," he said.