Inside Capitol Hill's Fight for Diabetes Care: What These Advocates Need You to Know

Episode Summary

Podcast: Diabetes Connections | Type 1 Diabetes

Host: Stacey Simms
Guest: George Huntley, CEO of Diabetes Patient Advocacy Coalition (DPAC)
Episode: Inside Capitol Hill's Fight for Diabetes Care: What These Advocates Need You to Know
Date: December 9, 2025

Main Theme

This episode explores current diabetes policy issues in Washington D.C.—focusing on Medicare changes, the politics of drug pricing, GLP-1 medication access, and the impact of patient advocacy. Stacey Sims and DPAC CEO George Huntley discuss how legislative and administrative actions affect people with diabetes, what advocacy can accomplish, and practical steps listeners can take to get involved.

Key Discussion Points & Insights

1. What is DPAC and How Can Listeners Get Involved?

(04:13–06:15)

DPAC is a patient-focused advocacy group pushing for affordable, accessible, and equitable diabetes care.
Founded and run by people with diabetes; most of the team are patients or close to diabetes.
Over 50,000 advocates across all 50 states; empowers individuals at the state and federal policy levels.
How to get involved:
- Sign up at diabetespac.org – easy, no spam.
- Also encouraged to sign up for advocacy alerts with diabetes.org and Breakthrough T1D—"This is a community, not a competition."

Quote:
“We don’t spam you, we don’t ask you for all of your life savings… When there’s legislative opportunities to weigh in, we provide you with those.” —George Huntley [05:22]

2. Medicare Competitive Bidding: Looming Threats to CGM and Pump Access

(06:24–16:10)

CMS Competitive Bidding Changes:
- CMS plans to reduce suppliers for CGM/pump coverage under Medicare from ~6,000 to 9, severely restricting access for seniors.
- Moving from an "own" to "rental" model, requiring patients to return devices before receiving new ones—causing major risk of care interruption.
- Historical precedent: Similar bidding on blood glucose monitors led to massive senior access disruption and increased mortality.
- Suppliers like Edge Park or Liberty Medical would become responsible for device support—a role they’re not prepared for.
- Changes sneakily announced after Thanksgiving. Effective in 2028, but advocacy continues; Congress could intervene.

Notable Quotes:

“They want to take the number of suppliers down from about 6,000 to nine or less, which is going to severely restrict senior citizen access.” —George Huntley [08:34]
“We've seen the movie before. They're going to take this down from 6,000 to nine. That's step one... step two, as if this could not get worse, they're changing the economic model to a rental versus an own.” —George Huntley [09:36]
“If I want another one in that lease model... I’m off pump therapy for one, two, three weeks, depending. I mean, the disruption in care for seniors is about to get off the chart if we don't get this fixed.” —George Huntley [11:25]
“I know many people who are [on MDI], but it's just not me. So... all the extra costs that Medicare is going to incur by this disruption process…” —George Huntley [12:09]
Stacey notes the importance of this topic: More people with T1D are living into older age than ever before; problems in Medicare policy will soon affect many.
Warning for younger listeners:
- “Commercial insurance very frequently follows Medicare. So if this model moves forward, I could easily see it landing in commercial insurance.” —George Huntley [16:43]

3. GLP-1 Medications: Shifting Access and the Future of Treatment

(17:35–24:32)

GLP-1s (like Ozempic, Wegovy):
- Transformative drugs for Type 2 diabetes & obesity; promise to reshape health spending by reducing complications.
- Long-term benefits—potential 39% drop in cancer rates, reversing Type 2 prevalence.
- Recent federal negotiations (Trump administration deals with Lilly/Novo) precipitated a dramatic price drop—from $1,200/month to ~$450/month.
- High demand—now “one in eight Americans” are reportedly taking these drugs.
- Employer health plans often see retention rise for employees with obesity; cheaper drugs may drive more universal coverage soon.
On Future Access for T1Ds:
- “If they're covering it for type two, they will likely cover it for type one. They may prior auth it... but they will eventually cover it.” —George Huntley [23:37]

Quotes:

“This is a class of drugs that will reshape this country and this world... the long term health benefits of these GLP1s we are barely scratching the surface on.” —George Huntley [17:54]
"I challenge anyone to look at any other drug class in the last 20 years where you've seen the list price... get cut to a third." —George Huntley [21:00]

4. The Broader Cost Debate: Are We Spending Too Much?

(24:32–27:27)

Criticism: Some say Medicare and health expenses are unsustainable.
Response: Drug costs are a small part of health plan spending; most goes to major medical, hospitalizations, and complications which GLP-1s and good diabetes management can prevent.
DPAC’s Approach: Advocating for “math and ROI (return on investment)” in health policy. Education, technology, and access ultimately save money.

Quote:

"Drugs will make the headlines, but it's not what's driving the cost of a health plan..." —George Huntley [25:09]
“The person with diabetes who knows the most lives the longest. And that's the absolute reason to invest in education.” —George Huntley (referencing Elliot Joslin) [26:40]

5. The State of Insurance Marketplaces and Subsidies

(27:27–30:18)

ACA/Obamacare Concerns:
- Marketplace premiums are spiking, even for non-subsidized plans; Huntley suspects shenanigans and profiteering.
- DPAC encourages pressure on Congress to extend premium subsidies.
- Looming Medicaid cuts may result in a 57% increase in the uninsured rate, leading to more rural hospital closures and strained ERs.

Quotes:

“You are quite correct. And the increases that hit the exchanges this year... I agree there’s likely some substantial profiteering going on…” —George Huntley [28:33]
“You're going to have almost a 57% increase in the uninsured population of this country. That's a massive number… You're going to see more and more closures, and we've seen enough of those.” —George Huntley [29:00]

6. What Advocacy Achieves: Past Wins & Next Steps

(30:18–32:09)

DPAC's Track Record:
- Successful passing of state-level PBM (Pharmacy Benefit Manager) reforms and rebate pass-through laws.
- Leading coalitions like the Patient Pocket Protector Coalition with dozens of nonprofits—broadening advocacy beyond diabetes.
- “There were 1200 PBM-related bills at the state level in 2025. That's insane. We've never seen anything like that.”
On Needed Voices:
- Real-life patient stories sway legislators—"it takes four people to get a law changed: the champion in the legislature, scientific evidence, economic evidence, and the patient voice." [32:23]

Quotes:

“I'm very proud of this team and all the advocates that we've got... We've passed so many laws at state level that it's exciting.” —George Huntley [30:33]
“Everywhere you turn, there's another opportunity. So we're just getting started and we're making good progress.” —George Huntley [32:09]

How to Advocate & Take Action

(32:09–34:15)

Concrete steps:
- Tell your personal story—legislators work for you.
- Sign up for alerts and calls to action at:
- Call and visit local Congressional or state offices.
If you’re a healthcare provider: Your voice is crucial, too!

Quotes:

“If these are patients listening to us, right? Tell your patient story. It takes four people to get a law changed... And if you don’t have all four of those things, the bill dies most of the time. You’ve got to have the patient voice.” —George Huntley [32:23]
“This is not a time to stay quiet on your couch.” —George Huntley [30:18], paraphrased

Memorable Moments & Tone

Stacey keeps things energetic, direct, and occasionally wry ("So this is about...well, there's a lot of bad news, George" [07:25]).
George balances deep expertise (“I'm a money guy, I'm a finance guy in my career…”) with personal experience (“I've been living with Type 1 since 1983”).
Both express hope—despite frustrations—at collective advocacy wins.

Timestamps for Key Segments

[04:17] DPAC mission, how to join, the need for collaborative advocacy
[06:24] Recent action on Capitol Hill, overview of Medicare changes
[07:36] CMS competitive bidding—detailed consequences for CGM and pump patients
[16:10] The aging T1D population & why this matters for everyone
[17:35] GLP-1s: cost, impact, future prospects for T1D and T2D
[24:32] National insurance costs and the counter-argument
[27:27] ACA/Obamacare marketplace turmoil and Medicaid cuts
[30:18] DPAC’s legislative achievements and progress
[32:09] How to be an advocate and tell your diabetes story

Conclusion

This episode underscores the vital importance of patient advocacy in shaping diabetes policy. George Huntley and Stacey Simms emphasize that change is possible—often slowly, sometimes frustratingly—but always more likely when patients, families, and supporters stay informed, united, and vocal. There’s still much to fight for: access, affordability, technology, and dignity for all living with diabetes.

For more info, full links, and resources:
Visit diabetes-connections.com

Episode Summary

Podcast: Diabetes Connections | Type 1 Diabetes

Main Theme

Key Discussion Points & Insights

1. What is DPAC and How Can Listeners Get Involved?

(04:13–06:15)

DPAC is a patient-focused advocacy group pushing for affordable, accessible, and equitable diabetes care.
Founded and run by people with diabetes; most of the team are patients or close to diabetes.
Over 50,000 advocates across all 50 states; empowers individuals at the state and federal policy levels.
How to get involved:
- Sign up at diabetespac.org – easy, no spam.
- Also encouraged to sign up for advocacy alerts with diabetes.org and Breakthrough T1D—"This is a community, not a competition."

Quote:
“We don’t spam you, we don’t ask you for all of your life savings… When there’s legislative opportunities to weigh in, we provide you with those.” —George Huntley [05:22]

2. Medicare Competitive Bidding: Looming Threats to CGM and Pump Access

(06:24–16:10)

CMS Competitive Bidding Changes:
- CMS plans to reduce suppliers for CGM/pump coverage under Medicare from ~6,000 to 9, severely restricting access for seniors.
- Moving from an "own" to "rental" model, requiring patients to return devices before receiving new ones—causing major risk of care interruption.
- Historical precedent: Similar bidding on blood glucose monitors led to massive senior access disruption and increased mortality.
- Suppliers like Edge Park or Liberty Medical would become responsible for device support—a role they’re not prepared for.
- Changes sneakily announced after Thanksgiving. Effective in 2028, but advocacy continues; Congress could intervene.

Notable Quotes:

“They want to take the number of suppliers down from about 6,000 to nine or less, which is going to severely restrict senior citizen access.” —George Huntley [08:34]
“We've seen the movie before. They're going to take this down from 6,000 to nine. That's step one... step two, as if this could not get worse, they're changing the economic model to a rental versus an own.” —George Huntley [09:36]
“If I want another one in that lease model... I’m off pump therapy for one, two, three weeks, depending. I mean, the disruption in care for seniors is about to get off the chart if we don't get this fixed.” —George Huntley [11:25]
“I know many people who are [on MDI], but it's just not me. So... all the extra costs that Medicare is going to incur by this disruption process…” —George Huntley [12:09]
Stacey notes the importance of this topic: More people with T1D are living into older age than ever before; problems in Medicare policy will soon affect many.
Warning for younger listeners:
- “Commercial insurance very frequently follows Medicare. So if this model moves forward, I could easily see it landing in commercial insurance.” —George Huntley [16:43]

3. GLP-1 Medications: Shifting Access and the Future of Treatment

(17:35–24:32)

GLP-1s (like Ozempic, Wegovy):
- Transformative drugs for Type 2 diabetes & obesity; promise to reshape health spending by reducing complications.
- Long-term benefits—potential 39% drop in cancer rates, reversing Type 2 prevalence.
- Recent federal negotiations (Trump administration deals with Lilly/Novo) precipitated a dramatic price drop—from $1,200/month to ~$450/month.
- High demand—now “one in eight Americans” are reportedly taking these drugs.
- Employer health plans often see retention rise for employees with obesity; cheaper drugs may drive more universal coverage soon.
On Future Access for T1Ds:
- “If they're covering it for type two, they will likely cover it for type one. They may prior auth it... but they will eventually cover it.” —George Huntley [23:37]

Quotes:

“This is a class of drugs that will reshape this country and this world... the long term health benefits of these GLP1s we are barely scratching the surface on.” —George Huntley [17:54]
"I challenge anyone to look at any other drug class in the last 20 years where you've seen the list price... get cut to a third." —George Huntley [21:00]

4. The Broader Cost Debate: Are We Spending Too Much?

(24:32–27:27)

Criticism: Some say Medicare and health expenses are unsustainable.
Response: Drug costs are a small part of health plan spending; most goes to major medical, hospitalizations, and complications which GLP-1s and good diabetes management can prevent.
DPAC’s Approach: Advocating for “math and ROI (return on investment)” in health policy. Education, technology, and access ultimately save money.

Quote:

"Drugs will make the headlines, but it's not what's driving the cost of a health plan..." —George Huntley [25:09]
“The person with diabetes who knows the most lives the longest. And that's the absolute reason to invest in education.” —George Huntley (referencing Elliot Joslin) [26:40]

5. The State of Insurance Marketplaces and Subsidies

(27:27–30:18)

ACA/Obamacare Concerns:
- Marketplace premiums are spiking, even for non-subsidized plans; Huntley suspects shenanigans and profiteering.
- DPAC encourages pressure on Congress to extend premium subsidies.
- Looming Medicaid cuts may result in a 57% increase in the uninsured rate, leading to more rural hospital closures and strained ERs.

Quotes:

“You are quite correct. And the increases that hit the exchanges this year... I agree there’s likely some substantial profiteering going on…” —George Huntley [28:33]
“You're going to have almost a 57% increase in the uninsured population of this country. That's a massive number… You're going to see more and more closures, and we've seen enough of those.” —George Huntley [29:00]

6. What Advocacy Achieves: Past Wins & Next Steps

(30:18–32:09)

DPAC's Track Record:
- Successful passing of state-level PBM (Pharmacy Benefit Manager) reforms and rebate pass-through laws.
- Leading coalitions like the Patient Pocket Protector Coalition with dozens of nonprofits—broadening advocacy beyond diabetes.
- “There were 1200 PBM-related bills at the state level in 2025. That's insane. We've never seen anything like that.”
On Needed Voices:
- Real-life patient stories sway legislators—"it takes four people to get a law changed: the champion in the legislature, scientific evidence, economic evidence, and the patient voice." [32:23]

Quotes:

“I'm very proud of this team and all the advocates that we've got... We've passed so many laws at state level that it's exciting.” —George Huntley [30:33]
“Everywhere you turn, there's another opportunity. So we're just getting started and we're making good progress.” —George Huntley [32:09]

How to Advocate & Take Action

(32:09–34:15)

Concrete steps:
- Tell your personal story—legislators work for you.
- Sign up for alerts and calls to action at:
- Call and visit local Congressional or state offices.
If you’re a healthcare provider: Your voice is crucial, too!

Quotes:

“If these are patients listening to us, right? Tell your patient story. It takes four people to get a law changed... And if you don’t have all four of those things, the bill dies most of the time. You’ve got to have the patient voice.” —George Huntley [32:23]
“This is not a time to stay quiet on your couch.” —George Huntley [30:18], paraphrased

Memorable Moments & Tone

Stacey keeps things energetic, direct, and occasionally wry ("So this is about...well, there's a lot of bad news, George" [07:25]).
George balances deep expertise (“I'm a money guy, I'm a finance guy in my career…”) with personal experience (“I've been living with Type 1 since 1983”).
Both express hope—despite frustrations—at collective advocacy wins.

Timestamps for Key Segments

[04:17] DPAC mission, how to join, the need for collaborative advocacy
[06:24] Recent action on Capitol Hill, overview of Medicare changes
[07:36] CMS competitive bidding—detailed consequences for CGM and pump patients
[16:10] The aging T1D population & why this matters for everyone
[17:35] GLP-1s: cost, impact, future prospects for T1D and T2D
[24:32] National insurance costs and the counter-argument
[27:27] ACA/Obamacare marketplace turmoil and Medicaid cuts
[30:18] DPAC’s legislative achievements and progress
[32:09] How to be an advocate and tell your diabetes story

Conclusion

For more info, full links, and resources:
Visit diabetes-connections.com

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Summary

Episode Summary

Podcast: Diabetes Connections | Type 1 Diabetes

Main Theme

Key Discussion Points & Insights

1. What is DPAC and How Can Listeners Get Involved?

2. Medicare Competitive Bidding: Looming Threats to CGM and Pump Access

3. GLP-1 Medications: Shifting Access and the Future of Treatment

4. The Broader Cost Debate: Are We Spending Too Much?

5. The State of Insurance Marketplaces and Subsidies

6. What Advocacy Achieves: Past Wins & Next Steps

How to Advocate & Take Action

Memorable Moments & Tone

Timestamps for Key Segments

Conclusion

Summary

Episode Summary

Podcast: Diabetes Connections | Type 1 Diabetes

Main Theme

Key Discussion Points & Insights

1. What is DPAC and How Can Listeners Get Involved?

2. Medicare Competitive Bidding: Looming Threats to CGM and Pump Access

3. GLP-1 Medications: Shifting Access and the Future of Treatment

4. The Broader Cost Debate: Are We Spending Too Much?

5. The State of Insurance Marketplaces and Subsidies

6. What Advocacy Achieves: Past Wins & Next Steps

How to Advocate & Take Action

Memorable Moments & Tone

Timestamps for Key Segments

Conclusion