State Advocacy

2025

• Expanded continuous glucose monitor (CGM) Medicaid coverage effective October 1. Coverage was expanded for both people with type 1 and type 2 diabetes. This change will provide vital support for improved health outcomes.

2025

• Passed legislation (SB 1711) establishing an obesity treatment study committee to look at the costs and benefits of treating obesity in the state.
• Passed legislation (SB 1132) making continuous glucose monitors (CGMs) available via both the durable medical equipment (DME) and the pharmacy benefit in Medicaid. 

2024

• Passed legislation allowing schools to have undesignated glucagon if a student with diabetes has a low blood glucose (low blood sugar, also called hypoglycemia) emergency.

• March 2023: A law was passed requiring pharmacy benefit managers to pass 100% of rebates to the consumer at the point of sale to lower their medication costs.
• April 2023: A bill was signed that moves continuous glucose monitors (CGMs) in the Medicaid program to a pharmacy benefit to improve access.
• April 2023: A bill was signed that provides free breakfast and lunch to students who qualify for reduced school meals to help reduce food insecurity.

2025

• Enacted SB 40, capping insulin copays at $35 per 30 days and adding step therapy protections.
• Supported the successful passage of SB 41, requiring pharmacy benefit managers to be regulated in California.
• Supported the successful passage AB 1264, regulating ultra-processed foods in schools. 

2024

• Passed legislation, maintaining the California universal school meals commitment with an increase of $120.784 million in one-time spending and allocated $179.404 million for ongoing funding.
• Ensured students with diabetes were allowed an exemption in legislation creating a statewide cell phone ban in schools.
• Supported successful legislation allowing WIC benefits to be utilized at certified mobile farmers’ markets, expanding access to fresh produce to help address food insecurity.
• Supported successful legislation requiring schools to update safety plans to include a response plan for cardiac emergencies. Since heart disease and cardiac events are the number one cause of death for people with diabetes, having an emergency plan is a critical lifesaving measure.
• Supported successful legislation expanding CalFresh participation to help address food insecurity and improve nutrition.

2025

• Passed legislation (SB 48) which expands coverage of the National Diabetes Prevention Program, medical nutrition therapy, IBT, and metabolic bariatric surgery eligibility, as well as offers employers the option to cover obesity medications on their insurance plans.
• Protected continuous glucose monitor (CGM) appropriations in the state budget for expanded access on Colorado Medicaid.
• Protected access to obesity medications on the state employee health plan by grandfathering coverage for existing state employees.
• Protected funding appropriation for the reimbursement of community health workers in Medicaid.
• Protected healthy meals for students in schools’ funding.

2024

• Supported successful legislation extending prior authorization approvals to one year for medications used to treat chronic conditions on state-regulated health plans.
• Successfully supported the insulin enforcement program, aiding the ADA’s existing insulin safety net programs in the state.
• Expanded continuous glucose monitor (CGM) coverage in Colorado Medicaid to all people with diabetes who use insulin, regardless of the number of injections needed per day.
• Supported successful local advocacy, including default beverage campaigns for children’s meals at fast food restaurants, which passed in Denver and Louisville at the municipal level. 

2025

• Successfully championed Connecticut Medicaid obesity coverage.
• Successfully opposed the complete removal of medication coverage and protected some level of access through older generation obesity medication coverage.

June 2023: A bill was signed that provides person-centered obesity treatment, including anti-obesity medication and nutritional counseling, for Medicaid and HUSKY B beneficiaries.

2025

• Passed legislation allowing schools to stock undesignated glucagon which can be administered in an emergency to a child living with diabetes whose glucagon prescription has expired or is not available.   

May 2023: A bill was signed that expands the definition of telehealth to allows audio-only visits.

June 2023: A bill was signed which expands eligibility for continuous glucose monitors (CGMs) to all Floridians on Medicaid with diabetes who are insulin dependent. The law adds adult coverage for the benefit, reduces coverage requirements, and directed that CGMs be made available through pharmacies to improve access.

2024

• Passed legislation eliminating barriers to continuous glucose monitor (CGM) access in the Medicaid program. A Medicaid beneficiary is now eligible for a CGM if they have diabetes, use insulin, and are trained on how to use a CGM. 

April 2023: A bill was signed that allows for undesignated glucagon to be prescribed in the school setting to provide a backup supply.

2024

• Signed legislation into law in July 2024 requiring continuous glucose monitor (CGM) coverage in state-regulated health plans and eliminated barriers to CGM access among Medicaid beneficiaries by closely aligning Illinois’ Medicaid coverage policy with Medicare. The Medicaid provisions became effective immediately and other health plan coverage will become effective January 1, 2026.

June 2023: The state budget includes $950k for diabetes research and programs.

June 2023: The state budget provides coverage to state employees for injectable medicines to improve glucose or weight loss for use by adults diagnosed or previously diagnosed with prediabetes, gestational diabetes, or obesity.

August 2023: A bill was signed to reduce cost-sharing on insulin from $100 to $35 for a 30-day supply for those with state-regulated commercial health insurance. The new law, effective July 1, 2025, also creates an insulin discount program allowing Illinoisans, particularly those with no health insurance or on a high deductible health plan, to purchase insulin at a discounted price.

May 2023: Legislation was signed into law to pass on at least 85% of rebates to the customer at the point of sale to lower medication costs.

2025

• Supported the successful passage of HF 303 to exempt health care providers from certain prior authorization requirements.
• Supported the successful passage of SF 383 to ensure the value of copay assistance programs is applied toward a patient’s deductible and out-of-pocket maximum.

2024

• Added continuous glucose monitor (CGM) coverage to Iowa Medicaid for those with gestational diabetes (GDM) and eliminated a barrier to access.
• Passed legislation extending postpartum Medicaid coverage from 60 days to 12 months.
• Passed legislation prohibiting health plans from making changes to prescription drug formularies in the middle of a plan year.  This allows coverage to continue for patients whose medication continues to be prescribed by their physician for their diabetes or other conditions. 

2025

• Championed HB 970, a first-in-nation, ADA-sponsored legislation prohibiting step therapy for insulin prescriptions, which was signed into Maryland law. Step therapy is a tool that insurers use to restrict access to medication that may be prescribed by a doctor. 

2025

• Passed a law addressing prescription drug affordability, including an ADA-supported cost-sharing limit of $25 on insulin in state-regulated health plans.
• Updated school medication administration regulations to allow for the training of non-medical staff in schools to administer glucagon in a hypoglycemic emergency.  

2024

• Passed legislation addressing prescription drug affordability, including the provision of an ADA-supported cap of $25 on insulin copays for state-regulated and public employee health plans.

June 2023: Medicaid’s revised continuous glucose monitor (CGM) policy goes into effect—expanding coverage to those with type 2 and gestational diabetes—eliminating the requirements for three or more insulin administrations per day, multiple daily blood glucose testing, and frequent adjustment to insulin. It has also eliminated prior authorization for those beneficiaries with type 1 diabetes and gestational diabetes.

2024

• Passed legislation reforming prior authorization requirements. Specifically, the ADA supported a provision eliminating the expiration for a prior authorization for a chronic disease lasting more than one year unless treatment has changed.
• Passed legislation reducing the burden of medical debt, helping Minnesotans receive necessary care. For people diagnosed with diabetes, medical expenditures are two times higher than would be expected without diabetes. 

May 2023: A bill was signed into law capping copayments for medications needed to treat chronic diseases, including diabetes. The bill caps copayments for prescription medication at $25 per prescription and $50 cumulative for supplies (both for 30-day supplies). 

2024

• Updated Medicaid coverage to allow easier access to continuous glucose monitors (CGMs), including as a pharmacy benefit.

March 2023: A bill was signed that extends Medicaid coverage to 12 months postpartum.

• May 2023: A bill was signed into law related to state-regulated health insurance and caps copayments for insulin at $35 per prescription per 30-day supply.
• May 2023: A new law updates state-regulated health insurance coverage for diabetes self-management education and support (DSMES) services, aligning the coverage with current standards of care. Under the new law, people will have access to up to 20 visits of DSMES services in the first year and 12 follow-up visits in subsequent years.

2024

• Passed legislation providing Medicaid coverage for  continuous glucose monitors (CGMs) for eligible pregnant mothers with gestational diabetes (GDM) and all individuals using insulin. 

January 2023: The finalized Medicaid continuous glucose monitor (CGM) policy includes coverage for all types of diabetes when medical necessity criteria is met. The policy also makes CGMs available through both the pharmacy and medical benefit, further improving access.

June 2023: A bill was signed into law to cap cost-sharing for insulin at $35 per 30-day supply for state employees and those in state-regulated health plans.

June 2023: A bill was signed to require the submission of a state plan amendment to extend postpartum Medicaid coverage from 60 days to at least six months (with the authority to submit a SPA for 12 months).

2025

• Supported successful legislation (AB 555) creating a $35 insulin copay cap for a 30-day insulin supply on all state-regulated health plans.
• Supported successful legislation (SB 292) adding Medigap coverage for those under 65.

2024

• Passed legislation providing Medicaid coverage for  continuous glucose monitors (CGMs) for eligible pregnant mothers with gestational diabetes (GDM) and all individuals using insulin.
• Increased Nevada Medicaid access to continuous glucose monitors (CGMs) to a broader group of beneficiaries and eliminated other barriers.

January 2023: The finalized Medicaid continuous glucose monitor (CGM) policy includes coverage for all types of diabetes when medical necessity criteria is met. The policy also makes CGMs available through both the pharmacy and medical benefit, further improving access.

June 2023: A bill was signed into law to cap cost-sharing for insulin at $35 per 30-day supply for state employees and those in state-regulated health plans.

June 2023: A bill was signed to require the submission of a state plan amendment to extend postpartum Medicaid coverage from 60 days to at least six months (with the authority to submit a SPA for 12 months).

2025

• Supported successful legislation (A1406) which focused on addressing child and adolescent obesity by supporting student nutrition. The new law requires public and certain private schools to comply with lunch and breakfast nutrition standards adopted by the United States Department of Agriculture in 2024, or any more stringent standards adopted thereafter. These standards include reducing calories, sodium, and saturated fat in school meals and increasing the offerings of grains, fruits, vegetables, and non-fat milk.
• Supported successful legislation (SB 2886), which requires pharmacies to provide information on insulin manufacturer assistance programs.
• Supported successful legislation (A1825) which requires health insurance carriers and utilization review organizations to meet certain guidelines in the administration and review of step therapy protocols.

July 2023: New Jersey has become the 25th state (as well as the District of Columbia) to cap out-of-pocket costs for insulin at $35 per 30-day supply for state-regulated health plans (and includes public employee health plans as well).

2025

• Passed first-in-nation coverage of topical oxygen therapy for the treatment of diabetes-related foot ulcers on state-regulated health plans.

2024

• Eliminated insulin cost sharing altogether for individuals on state-regulated health plans, becoming the first state in the nation to do so. 

2024

• Increased North Carolina Medicaid continuous glucose monitor (CGM) access and removed eligibility criteria barriers.
• Updated North Carolina Medicaid to cover obesity medication for its beneficiaries diagnosed with obesity.

March 2023: North Carolina became the 40th state to expand Medicaid. Once implemented, the expansion is expected to provide insurance for over 600,000 North Carolinians. 

2025

• Passed a law limiting cost sharing for state regulated plans at $25 for a 30-day supply of insulin and certain basic supplies.

April 2023: North Dakota passed legislation to cap copayments for the public employee health plan. The law created a $25 insulin copay cap and $25 cumulative copayment cap for supplies (both for 30-day supplies). 

2025

The ADA’s advocacy against the elimination of coverage for GLP-1 medications as an obesity treatment for state employees helped lead to the development of a new state program to offer limited reimbursement for the medications. Advocacy continues in order to restore full coverage.

July 2023: The Ohio budget contains a provision whereby all students who qualify for reduced-priced meals will be eligible for free meals (both breakfast and lunch).

• April 2023: A bill was signed improving consumer protections related to step therapy protocols used by health plans.
• May 2023: A bill was signed that allows for undesignated glucagon to be prescribed in the school setting to help ensure backup glucagon is available.

2024

• Passed legislation lowering the cap on the cost of insulin to $35 per month for state-regulated health insurance, preventing future cost increases. 

2024

• Updated Medicaid criteria and removed eligibility barriers for CGMs, improving access.
• Updated Medicaid policy, allowing obesity medication to be offered to Medicaid beneficiaries.

2025

• Supported the successful passage of a budget provision to expand obesity coverage for Medicaid enrollees.
• Supported the successful passage of SB 680 to require the distribution of informational materials regarding type 1 and type 2 diabetes for parents, guardians, and caregivers of students in public and public charter schools.

April 2023: Passage of the state budget will result in TennCare (Medicaid) beginning to offer coverage for continuous glucose monitors (CGMs) (both through the pharmacy and DME benefit) effective July 1, 2023, improving ease of access.

2025

• Passed legislation which requires that a study be conducted by the Texas Health and Human Services Commission to evaluate the feasibility of a diabetes prevention program for Medicaid recipients, including alternative weight-loss interventions to lower risk for type 2 diabetes.
• Successfully championed legislation requiring a study of amputation prevention measures and policy recommendations for the legislature and executive branch on ways to reduce diabetes amputation.

2024

• Updated Medicaid criteria removing eligibility barriers to continuous glucose monitors (CGMs). 

2025

• Passed legislation (SB 146) allowing for universal glucagon access in schools. 

2025

• Supported successful legislation (SB 1016), which establishes a food pantry grant program at institutions of higher learning. 

2025

• Championed successful budget action which reduced barriers to continuous glucose monitor (CGM) access among Medicaid beneficiaries. 

2024

• Passed legislation enabling Virginia schools to stock undesignated glucagon for students who have a medical plan in place for their diabetes.
• Passed legislation prohibiting certain medical care facilities, certain health care professionals, and emergency medical services agencies from reporting any portion of a medical debt, defined in the bill, to a consumer reporting agency. The bill also prohibits collection entities from reporting such collection or attempts to collect to a consumer reporting agency.

March 2023: A law was passed that allows pharmacists to refill prescriptions for insulin in an emergency without updated authorization from the current prescriber. 

2025

• The Washington Health Technology Clinical Committee approved coverage changes that will improve access to CGMs. These ADA-championed changes are expected to apply to Medicaid, public employees, and school employee plans.
• Successfully advocated for obesity analysis language that was included in the state operations budget bill. The office of the insurance commissioner will be required to do an analysis of utilization and cost impacts for providing coverage of obesity treatment benefits for state-regulated commercial health plans.
• Removed budget language that would pause the release of the Diabetes Epidemic Action Report for 2025–2027.

May 2023: A law was passed that removes the January 1, 2024 expiration date for the state’s $35 insulin copay cap. 

2025

• Included recommended language in HB 2003 to ensure students with diabetes will continue to have access to their smart phones to monitor and treat their diabetes.
• Successfully advocated against HB 3518 to potentially disenroll 166,000 West Virginians from Medicaid. 

March 2023: The budget includes $97,125 in funding for diabetes education and prevention programs.

March 2023: A bill was signed into law related to state-regulated health insurance plans. The law will reduce cost-sharing on insulin from $100 to $35 for a 30-day supply and set a similar, collective cost-sharing limit of $100 on continuous glucose monitors (CGMs), blood glucose test strips, glucometers, lancets, lancing devices, and insulin syringes.

2025

• Supported a budget appropriation to each tribal health department to address diabetes prevention and management.

2024

• Passed legislation allowing certain health care providers to prescribe glucagon in the name of a school and for the school to maintain a supply of the glucagon for use when a student with diabetes experiences potentially severe hypoglycemia.
• Passed legislation creating a healthy food incentive program to provide matching dollars to purchase produce at participating retail locations.
• Updated Medicaid continuous glucose monitor coverage policy to eliminate the requirement for multiple daily administrations of insulin. The revised policy also established a single coverage policy for all beneficiaries regardless of age and eliminates much of the unnecessary prior authorization requirements. 

February 2023: A bill was signed into law to add Medicaid coverage for podiatry services.