Impact of the Affordable Care Act on diabetes diagnoses in the United States: A county‐level analysis

Abstract

Our research examines whether there is a causal effect between expanding health insurance and diabetes incidence. Comprehensive county‐level data from the United States is used to study the effect of Medicaid expansion on diabetes rates. The analysis is based on cross‐county variation according to Affordable Care Act health care reforms, along with county share‐eligibility variation. Difference‐in‐difference and triple‐difference statistical regression specifications are employed to control for confounding variables. The results suggest a slight negative relationship between expanding health insurance and diabetes diagnoses.

Effect of the Affordable Care Act on diabetes care at major health centers: newly detected diabetes and diabetes medication management

“…Different from individuals who had no access to healthcare 2 before the ACA, our sample of patients from socially deprived tracts shows no increase in rates of newly diagnosed diabetes ( figure 1 ). An insignificant drop of −0.72 (95% CI −3.22 to 1.77) in newly diagnosed diabetes for the treated group was detected.…”

“…The adoption of the Affordable Care Act (ACA) 1 in the USA expanded health insurance for low-income Americans and took two main forms: Medicaid expansion in some states and subsidized private health insurance through insurance exchanges available in all states, with deep subsidies for persons with incomes from 138% to 250% of the federal poverty limit (FPL) in Medicaid expansion states and from 100% to 250% of the FPL in non-expansion states. Prior studies found a statistically significant slightly negative 2 effects of the ACA on diabetes diagnoses and controversial (from insignificantly slightly positive 3 to significantly positive 4 ) effects on diabetes therapies at county and state levels. We examined the effect of both forms of ACA reform on the improvement of diabetes diagnostics and management in low-income patients who had access to healthcare before the ACA expansion (2011–2013).…”