States that expanded Medicaid under the ACA have significantly higher rates of diabetes diagnoses compared with patients in states that did not expand coverage, according to new data.
“This seminal study demonstrates that the ACA promotes earlier diagnosis of one of the prevalent and treatable chronic health conditions in the United States. But these benefits were not shared equally across states,” Vivian A. Fonseca, MD, FRCP, of Tulane University School of Medicine, New Orleans, said in a press release.
Researchers evaluated the Quest Diagnostics database for newly identified diabetes cases, aged 19 to 64 years, within the first 6 months of 2013 (n = 215,398) and 2014 (n = 218,890), to assess the impact of states with Medicaid expansion versus states without.
Between 2013 and 2014, there was a 1.6% increase in newly diagnosed diabetes among patients. Among Medicaid enrolled patients, a 13% increase in diabetes diagnoses were seen from the 2013 control period to the study period of 2014.
The 26 states, and the District of Columbia, that expanded Medicaid had a 23% increase in newly identified diabetes patients compared with only a 0.4% increase in the 24 states that did not expand coverage.
“Improved access and use of medical services may in turn lead to earlier diagnosis of associated diseases and permit earlier intervention to reduce long-term complications,” the researchers wrote.
“This study demonstrates the need for additional debate on the merits of health care reform to promote equal access to health services,” Fonseca said in the release.
In an accompanying editorial, William H. Herman, MD, MPH, Department of Internal Medicine, University of Michigan and William T. Cefalu, MD, Pennington Biomedical Center, Louisiana State University urged policy makers to look to the benefits of Medicaid expansion among diabetes diagnoses to address the increasing problem of other chronic diseases.
“Kaufman et al. have again demonstrated that Medicaid expansion increases the number of low-income Americans with newly identified diabetes and will likely improve their outcomes. The data demonstrates the benefits of Medicaid expansion, yet nearly half of our states have chosen not to expand this benefit to their citizens,” Herman and Cefalu wrote. – by Casey Hower
Disclosures: Kaufman reports no relevant financial disclosures. See the full studies for lists of all other authors’ relevant financial disclosures.
