Expanding Medicaid under ACA helped to identify 23 percent more people with previously undiagnosed diabetes

http://www.eurekalert.org/pub_releases/2015-03/ada-emu031215.php

Public Release: 23-Mar-2015
American Diabetes Association

States that have expanded their Medicaid programs under the Affordable Care Act (ACA) are capturing an increased number of people with previously undiagnosed diabetes, allowing them to begin treatment earlier, potentially reducing complications and other negative outcomes, according to a study being published online today and in the May issue of Diabetes Care.

The release of the study coincides with the 5th anniversary of the ACA, which expanded Medicaid eligibility to reach nearly all non-elderly adults with incomes at or below 138 percent of the federal poverty level (about $16,105 for individuals), while giving states the option of offering this expanded coverage. Twenty-six states chose to do so, while 24 states did not. The study compared increases in patients with newly diagnosed diabetes in both groups, finding a 23 percent increase in newly diagnosed diabetes patients in states that expanded their Medicaid programs, compared to a 0.4 percent increase in states that did not.

"The division of states created an opportunity to examine the impact of Medicaid expansion on specific health metrics, such as detection of disease," wrote the authors of the study, who relied upon the Quest Diagnostics database to identify newly diagnosed patients with both type 1 and type 2 diabetes. Diabetes was chosen, the authors noted, because it has such a large at-risk population and because "aggressive prevention and treatment programs have been shown to improve outcomes."

"Clearly, expanding Medicaid has allowed those 26 states that did so to identify a large number of people who previously did not know they were living with diabetes," said Vivian Fonseca, MD, Professor of Medicine and Pharmacology, Tullis Tulane Alumni Chair in Diabetes Chief, Section of Endocrinology at the Tulane University Health Sciences Center, Tulane University School of Medicine. "Early identification can be potentially life-saving for people with diabetes, and can at the very least greatly increase the chances of preventing or delaying complications. Data on prevention of complications comes from several trials funded by the National Institutes of Health, American Diabetes Association and others. In the long term, such prevention of complications has been shown to be cost saving, since the complications -- including blindness, amputations and kidney failure requiring dialysis or transplant -- are extremely expensive."

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