Medicaid Expansion Under Health Reform May Increase Service Use And Improve Access for Low-Income Adults With Diabetes

Abstract

Medicaid's key role in financing diabetes care will grow when many low-income uninsured people with diabetes gain eligibility to the program in 2014 under the Affordable Care Act. Using a national data set to describe current health care use and spending among the nonelderly, low-income adult population, we found that adult Medicaid beneficiaries with diabetes had total annual per capita health expenditures more than three times higher ($14,229 versus $4,568) than those of adult beneficiaries without diabetes. At the same time, Medicaid facilitates financial protection and care access among beneficiaries with diabetes. Low-income adults with diabetes who were uninsured used fewer services, spent more out of pocket, and reported worse access than did their peers who were covered by Medicaid. Uninsured adults with diabetes who gain Medicaid coverage under health reform are likely to enter the program with unmet needs, and coverage is likely to result in both improved access and increased use of health care.

Race/Ethnicity, insurance, income and access to care: the influence of health status

“…Furthermore, more than half of uninsured adults did not visit a doctor in 2010 [23]. Lastly, low income is another barrier to access to care [25,27-29]. However, research has pointed out that even among high-income adults, those uninsured still have significantly lower use of recommended health care services than the insured [30].…”

Did Health Care Reform Help Kentucky Address Disparities in Coverage and Access to Care among the Poor?

“…). Medicaid and CHIP have already been shown to have an effect on alleviating the burden of high medical expenses (Gross and Notowidigdo ; Sommers and Oellerich ; Wherry, Kenney, and Sommers ), which may increase the share of the low‐income population with chronic conditions who then have the ability to afford adequate chronic disease management (Garfield and Damico ).…”

Where You Live Matters: Quality and Racial/Ethnic Disparities in Schizophrenia Care in Four State Medicaid Programs

“…At a time of unprecedented expansion of the Medicaid program and rekindled interest in understanding its health impacts (Garfield and Damico ; Sommers, Baicker, and Epstein ; Baicker et al. ), efforts are underway to improve quality and narrow racial/ethnic disparities in Medicaid care.…”