Uninsured rate among diabetics dropped after ACA

The Affordable Care Act had a profound impact on the uninsured rate of U.S. adults with diabetes, according to a recent study from University of Southern California published in the journal of the American Diabetes Association, Diabetes Care.

Health insurance coverage is particularly important for people with diabetes and can change their health trajectory “by facilitating timely diabetes diagnosis and management,” wrote first author Rebecca Myerson, MPH, PhD, an assistant professor of pharmaceutical and health economics at the school of pharmacy at USC, and colleagues.

From 2009 to 2016, insurance coverage for adults with diabetes rose following the implementation of certain ACA provisions. Researchers examined 2,401 U.S. adults with diabetes and discovered uninsured rates among this group dropped 12% as a result of the ACA, and 27% among those with low income.

When extrapolated to the U.S. population on nonelderly adults with diabetes, that means 1.9 million––including 1.2 million low-income adults––gained health insurance coverage after ACA implementation.

“In summary, an additional 1.9 million people with diabetes more than half of whom had low income gained insurance coverage under the ACA, after adjustment for respondent characteristics and secular trends,” Myerson et al. wrote. “Given that insurance reduces the financial strain of health care utilization, the coverage gains among people with low income may be particularly impactful.”

Prior to the ACA, in 2009-2019, 17% of nonelderly adults with diabetes, 33% of those with low incomes, were uninsured. In the same time period, roughly 25% of adults with undiagnosed diabetes were not insured. Among the undiagnosed group, uninsured rates dropped 17% after the ACA was implemented.

The study did not include people whose diabetes was undiagnosed, which could constitute about one-third of all adults with diabetes prior to the healthcare law. Researchers used the National Health and Nutrition Examination Survey (NAHNES) to look ant insurance changes under the ACA for those with diabetes and those with undiagnosed diabetes to fill in that gap.