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Lawmakers weigh mandating insurer coverage for glucose monitoring devices; department flags cost and scope issues
Summary
A subcommittee heard from medical witnesses, carriers and the Insurance Department on Bill 1571, a proposed mandate to require coverage of continuous glucose monitors and test supplies. The Insurance Department modeled an assumed 26% uptake and estimated median per-user costs and fiscal impacts; members urged sponsors to narrow the bill's scope before further action.
The Commerce and Consumer Affairs subcommittee examined Bill 1571, which would mandate insurer coverage of glucose monitoring technologies and related supplies. Jason Aziz, director of economics at the New Hampshire Insurance Department, told the committee the department modeled the bill assuming a 26% uptake among the newly eligible population — a figure drawn from prior uptake among type 1 diabetics and type 2 diabetics on insulin — and estimated a median per-patient annual cost (device, supplies and diabetes-educator visits) of about $1,380. Aziz said the department’s modeling yielded an "approximate annualized cost [of] about $13.80 a year for all parts of the legislation," a per-enrollee figure spread across the commercial insured population in the analysis.
Witnesses and committee members debated the appropriate scope of any mandate. Some members and medical witnesses argued for narrower eligibility focused on higher-risk patients — for example, people with hypoglycemia unawareness or those on insulin — while sponsors said the bill’s intent is broader, to cover monitoring approaches a patient would benefit from. Insurance staff and carriers described how coverage criteria have shifted in recent years: examples cited included Medicare/CMS guidance that relaxed injection-frequency thresholds for coverage in 2024, and evidence that commercial-carrier indications have been migrating as clinical guidance evolves.
Committee members pressed for details on current coverage and cost-sharing. Aziz said his report included a table showing that recent claims often had low or zero cost-sharing, but he and others warned that new eligibility could change uptake and long-term costs. Members urged sponsors to consult with major carriers and to refine draft language (for example by focusing on specific eligibility criteria) before the committee takes further action. No formal vote was recorded; committee members signaled they are unlikely to recommend the bill in its present, broad form and asked the department and sponsors to provide additional detail and narrower statutory language.
