Affordable Care Act shows big potential to help Americans with diabetes

"Our findings showed that from 2011 through 2012, shortly after passage of ACA, nearly 2 million working-age adults with diabetes lacked health insurance," said Derek Brown, PhD, assistant professor at the Brown School. "We also showed that access to care was a significant barrier among this population, and that proper diabetes care lagged among the insured on all indicators."

The study, Impact of the Affordable Care Act on Access to Care for US Adults With Diabetes, 2011-2012, was published in the journal Preventing Chronic Disease.

"To the extent that the ACA increases access and coverage, uninsured people with diabetes are likely to significantly increase their health-care use, which may lead to reduced incidence of diabetes complications and improved health," said Timothy McBride, PhD, co-author of the study and a professor and health economist at the Brown School.

Brown and McBride examined demographics, access to care, health-care use, and health-care expenditures of adults with diabetes aged 19-64 by using the 2011 and 2012 Medical Expenditure Panel Survey.

They found that uninsured adults reported poorer access to care than insured adults, such as having a usual source of health care and having lower rates of utilization of six key diabetes preventive-care services. Insured adults with diabetes were found to have significantly higher health-care expenditures than uninsured adults.

"Previous published work has shown that the uninsured face significant barriers to obtaining health care and face higher out-of-pocket health care costs than the insured," McBride said. "In addition, the uninsured can experience health problems as a result of the lack of access to medical care. Although much research has focused on the general uninsured population, few studies have focused on the population with diabetes."

The objective of this study, Brown said, was to gauge the potential impact of ACA on improving diabetes care through improved health-care access by comparing health care and health outcomes of a large national sample of insured and uninsured adults with diabetes.

"Our results provide a straightforward comparison of the gap between the insured and uninsured before health care reform, providing insights about how indicators for these two groups may converge in coming years," Brown said.