CA Black Health Network Applauds Improved Access to CGMs, Pushes for Equitable Qualifying Criteria

Rhonda M. Smith

The coronavirus pandemic shines a bright light on the social and health inequities that have long existed in Black and African American communities.

According to the California Health Care Foundation, the life expectancy at birth for Black Californians is 75.1 years - five years shorter than the state average and the lowest of all racial and ethnic groups.  

Black Californians fare significantly worse in maternal and infant health measures, with higher rates of first-birth cesareans, preterm births, infant mortality, and maternal mortality.

Due to structural barriers, systemic inequities, and social factors, Black Californians are more likely to suffer from underlying conditions related to COVID-19, such as diabetes. Studies indicate that Blacks are 1.5 times more likely to suffer from diabetes than their White counterparts. Additionally, studies show that Black Californians are more than twice as likely to undergo amputations due to diabetes complications.

The coronavirus pandemic highlights the critical need to address the disparities related to diabetes, which is the second leading cause of COVID-19 deaths and disproportionately impacts Black and Latino communities.  

In California, the COVID-19 mortality rate for Latinos is 20% higher than the statewide average and 10% higher among Blacks. These numbers are disheartening and unacceptable.

However, there is a glimmer of hope on the horizon when it comes to diabetes management. Just last month, the governor and state lawmakers approved a years-long effort by Assemblymember Adam Gray to allow Medi-Cal enrollees access to life-changing diabetes medical devices known as continuous glucose monitors or CGMs.

Multiple studies have documented the positive effects of CGMs in lowering hospitalization and risks of diabetes-related strokes, blindness, amputations - and more recently, COVID-19 complications.

For years, CGMs have been available to private insurance patients while Medi-Cal, which is largely comprised of people of color, required enrollees to use less reliable finger-stick glucose tests.

California took a critical step towards health equity by expanding CGM coverage to Medi-Cal enrollees. However, there is more work to be done.

Between now and when Medi-Cal coverage of CGMs begins on Jan. 1, 2022, the California Department of Health Care Services will lay out the criteria for who does and doesn't qualify for a CGM. The criteria could be as restrictive as limiting eligibility to those with Type I diabetes on insulin therapy, or it could be consistent with current medical practice to allow the enrollee's physician to determine medical necessity.

COVID-19, now accelerated by the Delta variant, continues to detrimentally impact our communities. Hospitalization rates are rising, and Black, Indigenous, and people of color continue to suffer at disproportionate rates.

Governor Newsom, Assemblymember Gray, and state lawmakers have taken critical steps to increase access to diabetes care in an equitable manner.

We now urge lawmakers, healthcare administrators and advocates to keep their finger on the pulse and ensure that equity is embedded in the qualifying criteria for Medi-Cal coverage of CGMs.

Source: California Black Health Network

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