Diabetes affects millions, yet barriers to affordable care and comprehensive coverage continue to undermine health outcomes and financial stability. Among those affected are people with insulin-requiring diabetes (IRD) who depend on access to essential services, including medications, supplies, and devices. With support from The Leona M. and Harry B. Helmsley Charitable Trust, CHIR researchers are analyzing how private health insurance coverage and the regulation thereof affect patients with IRD. Their findings aim to raise awareness and drive engagement on pressing private health insurance issues in this space.
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Rapid Response Diabetes Policy Series
Health care consumers, including millions of people living with insulin-requiring diabetes, are facing significant health insurance and coverage challenges. Some of these challenges are long-standing features of broken insurance and regulatory systems and some are directly resulting from policy shifts. The purpose of this series is to break down emerging coverage and affordability challenges and identify considerations for policymakers, diabetes patient advocates, and providers to protect access to affordable care for people with diabetes
- Leveraging Partnerships to Navigate Emerging Diabetes Coverage, Access, and Affordability Challenges
Diabetes Policy Dispatch
The Diabetes Policy Dispatch is a semi-regular publication from CHIR highlighting recent state and federal policy developments. Dispatch publications also provide considerations for diabetes stakeholders to inform public comments.
- Notice of Benefit and Payment Parameters 2027: Considerations for People with Insulin-Requiring Diabetes (Feb. 2026)
- CMS Prior Authorization and Interoperability Rule: What Diabetes Patient Advocates Need to Know (May 2026)
- 2027 Notice of Benefit and Payment Parameters: Final Rule and Diabetes Advocate Perspectives (June 2026)
Research Publications
CHIR focuses its diabetes research on state and federal policies that improve access to affordable diabetes care and treatment. Areas of focus include coverage of services according to the standard-of-care for insulin-requiring diabetes, cost-sharing for diabetes devices, medications, and supplies, and prior authorization and other utilization management techniques.
Issue Brief Series: Insulin-Requiring Diabetes Coverage, Affordability and Access in State-Regulated Insurance
CHIR experts conducted a literature review and informant interviews across five states plus the District of Columbia (“study states”) to assess the health insurance policy landscape for insulin-requiring diabetes in the state private health insurance market, including current pain points and relevant policy solutions.
- Executive Summary
- Issue Brief I: Improving Coverage
- Issue Brief II: Improving Cost-Sharing
- Issue Brief III: Improving Prior-Authorization
- State Spotlight: Colorado and the District of Columbia
- Appendices: Diabetes Care and State Insurance Requirements
Related Resources:
- Private Health Insurance: The Role of State Laws and Regulations
- The Role of Federal Regulation in Private Health Insurance
Prior Authorization Research
Using a third-party database of commercial insurance formulary and coverage criteria policy documents, CHIR is researching whether carrier prior authorization and medical necessity criteria are aligned with an evidence-based standard-of-care for insulin-requiring diabetes.
- Variability in Continuous Glucose Monitor Coverage in the Fully Insured Market – Executive Summary, Full Report
Related Blogs
CHIR has published a number of shorter pieces summarizing key research findings or state and federal policy trends related to diabetes coverage, affordability, and access.
- The 2027 Notice of Benefit and Payment Parameters: Final Rule and Diabetes Advocate Perspectives
- CMS Prior Authorization and Interoperability Proposed Rule: What Diabetes Patient Advocates Need to Know
- Notice of Benefit and Payment Parameters 2027: Considerations for People with Insulin-Requiring Diabetes
- Executive Summary: Variability in Continuous Glucose Monitor Coverage in the Fully Insured Market
- Full Report: Variability in Continuous Glucose Monitor Coverage in the Fully Insured Market
- Insulin-Requiring Diabetes Coverage, Affordability, and Access in State-Regulated Private Health Insurance
- Private Health Insurance: The Role of State Laws and Regulations
- The Role of Federal Regulation in Private Health Insurance
- Aligning Insurance and Evidence in Diabetes Care: Reflections on Recent Research
- Prior Authorization Reform Heats Up
- Translating Clinical Guidelines into Insurance Coverage Standards: High Stakes for Diabetes Access
- H.R. 1, Recently Enacted Federal Budget Law Spells Trouble for Patients with Insulin-Requiring Diabetes
- Health Insurance Transitions For Young People With Diabetes Can Be Life Threatening
- Using Health Insurance Reform to Reduce Disparities Diabetes Care
Events
CHIR hosts webinars geared toward diabetes providers, patient advocates, and policymakers to describe challenges in diabetes coverage, access, and affordability and to highlight state and policy solutions.
Webinar Recordings
- Diabetes Treatment Innovation: Moving from Standards of Care to Coverage
- Continuous Glucose Monitors: How Coverage Compares to Recommended Care for People with Diabetes
- Prior Authorization Reform Heats Up
- Diabetes Treatment Innovation: Moving from Standards of Care to Coverage
- Navigating New Coverage Changes: What People With Diabetes Need to Know
- Advancing Diabetes Coverage and Access: Looking Back on 2024 and Ahead to 2025
- Tackling Prior Authorization Barriers for Patients with Diabetes
- Tackling Diabetes Coverage and Affordability
Poster Presentations
Media Highlights
CHIR’s diabetes policy work has been quoted or featured in a variety of news outlets.
- Medscape, CGM Sweet Talk with the Sugar Queens, Beyond The Sensor: The Policy Shaping CMG Access (2026)
- Marketplace, Insurers Cutting Prior Authorization Requirement for Some Healthcare (2026)
- STAT, In a Financial Pinch, Major Health Insurers Are Turning to AI for Help (2026)
- An Arm and a Leg, Some Things That Didn’t Suck in 2025 (Really) (2025)