The Affordable Care Act’s Medicaid expansion has dramatically improved diabetes detection rates, according to a new study published in the journal Diabetes Care, which provides some of the strongest evidence of the law’s effectiveness to date.
The study, released to coincide with the fifth anniversary of the Affordable Care Act, found a 23 percent increase in newly diagnosed diabetes patients in the 26 states (and the District of Columbia) that expanded Medicaid last year. In the 24 states that did not expand Medicaid, the increase in newly diagnosed diabetes patients was only 0.4 percent.
“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,” Vivian Fonseca, a professor of medicine and pharmacology at Tulane University School of Medicine and one of the study’s authors, said in a statement to the American Diabetes Association.
These new findings are particularly significant, as they indicate that the historic coverage gains under the Affordable Care Act are already leading to systemic improvements in chronic disease detection. As the study’s authors note, catching and treating diabetes in its early stages can lead to improved long-term health outcomes and prevent a variety of serious comorbidities. “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,” Fonseca said.
Diabetes complications can include kidney disease, increased risk for stroke and poor circulation that can lead to amputations. The risk of death for adults with diabetes is 50 percent higher than it is for adults without the disease, according to the Centers for Disease Control and Prevention. Indeed, diabetes is an increasing — as well as increasingly costly — problem in the United States. More than 29 million people in the United States suffer from the disease, with one in every 10 health care dollars spent on diabetes. In 2012, diabetes cost the U.S. $245 billion, a 41 percent increase from five years prior.
Expanding Medicaid, a federally- and state-funded health insurance program for low-income individuals, to include everyone below 138 percent of the federal poverty level (roughly $16,105 for individuals) is one of the major goals of the ACA, which seeks to fundamentally transform health care by moving away from a reactive (treatment-based) system towards a proactive (prevention-based) one.
As the LA Times explains, “the architects of the Affordable Care Act had hoped that expanded access to health insurance, such as Medicaid, would ultimately improve Americans’ health. A growing body of evidence supports this conclusion, though some critics of the law have continued to question the link between insurance coverage and better health outcomes.”
But as more and more evidence demonstrates that the law is working, Dr. Georges C. Benjamin, executive director of the American Public Health Association, told the LA Times that it was time to end that debate. “This latest study is a strong health argument against those folks who want to repeal the Affordable Care Act,” he said.