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Subcommittee retains bill on insurance coverage for continuous glucose monitors; fiscal and eligibility questions remain
Summary
Members retained House Bill 648, which would expand insurer coverage of continuous glucose monitoring (CGM) devices. Lawmakers and the Insurance Department debated eligibility criteria, fiscal estimates, and clinical thresholds for coverage; committee voted to retain while staff and the department develop narrower language and cost estimates.
The House Commerce and Consumer Affairs subcommittee voted to retain House Bill 648, which would change insurance coverage rules for continuous glucose monitoring (CGM) devices used by people with diabetes.
Supporters argued CGMs can prevent complications and improve diabetes management; several members cautioned coverage criteria should be narrowly drawn to avoid large premium impacts. Representative Spear said a fiscal estimate he circulated suggested an added cost of about $22 per year per family member under the unamended bill, but department staff later explained that estimate applied to the unamended text and is no longer valid after the amendment that subjects devices to deductibles.
Jason Edge, director of health economics at the New Hampshire Insurance Department, presented the department’s fiscal approach and said the agency estimates the number of newly eligible people if the bill becomes law using insulin-therapy status as the eligibility baseline. Edge noted roughly 30–32 percent of people with type 2 diabetes are treated with insulin and that Medicare has recently reduced criteria for eligibility in some programs (change effective April 2024 was cited).
Representative Hope Damon, identified herself as a retired diabetes educator and dietitian, told the committee that CGM is especially important for people who need frequent monitoring and also highlighted barriers such as needle phobia, tremor disorders, workplace constraints and non-insulin therapies that can make finger-stick testing impractical. Committee members debated whether eligibility should be tied to insulin therapy or to clinical need as determined by the treating clinician.
Committee members asked the department to refine costs under the bill’s amended language. The committee retained HB 648 so staff, stakeholders and the department can develop more precise eligibility criteria and fiscal estimates; the motion to retain passed by a recorded tally the chair announced as 7–0.
The committee also requested working-group collaboration over the summer to draft clearer thresholds (for example, frequency-of-testing criteria or documented glucose variability) and to clarify whether a standalone prescription or an endocrinology referral should be required.
