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Affordable Care Act slashed the uninsured rate among people with diabetes

The dip in the uninsured rate was especially pronounced among those with low income.

Jeff Lagasse, Associate Editor

The Affordable Care Act provided health insurance for an estimated 1.9 million people with diabetes, according to a newly published study in the Journal Diabetes Care.

A research team analyzed information from 11 years of the National Health and Nutrition Examination Survey, which gathers data that's nationally representative of the civilian population.

The biennial survey includes biomarkers, including HbA1c, a measure of blood-sugar control. Using the NHANES data allowed the researchers to identify those with undiagnosed diabetes.

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In 2009 and 2010, 17% of adults who were under the age of 65 and had diabetes were uninsured. After the ACA took effect, that percentage declined by 12% -- and by 27% among those with low income.

Coverage gains were particularly strong among people whose diabetes was undiagnosed. In 2009 and 2010, about one in four adults under age 65 with undiagnosed diabetes lacked health insurance coverage. After the ACA was implemented, the uninsured rate in this group dropped by 17 percentage points, to 8%.

The sample used in the study included 2,400 U.S. citizens ages 26-64 with diabetes, defined as an HbA1c level at or greater than 6.5%, or a diabetes diagnosis by a healthcare professional. About one-third of all U.S. adults with diabetes don't know they have it.

The researchers estimate that, of the 1.9 million people with diabetes who gained coverage under the ACA, 1.2 million had low income -- defined in the study as below 138% of the federal poverty level.


Cigna recently announced it's expanding its Affordable Care Act offerings, moving into 19 markets across 10 states, including expansion into Kansas, South Florida and Utah.

Cigna and other insurers are expanding their footprint in the ACA market at a time when the Centers for Medicare and Medicaid Services reports enrollment is down among consumers who don't qualify for tax subsidies. CMS linked the decline to affordability issues.

In its seventh year, the ACA shows signs of growing stability, as measured by moderate premium increases and increased participation by health plans, according to the The Robert Wood Johnson Foundation in a report released last week.

Twitter: @JELagasse

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