A driving force for health equity

New Study Demonstrates ACA Medicaid Expansion Increases Preventative Care Access and Improves Health

More than 30 million people have diabetes in the United States and nearly 86 million are considered pre-diabetic or are at risk of developing diabetes, a costly chronic disease with higher than average rates among low-income populations. A study released in the Journal of the American Board of Family Medicine outlines the impact of the Affordable Care Act’s Medicaid expansion on visit rates for patients with diabetes or pre-diabetes in safety net health centers. This study demonstrates the power of health insurance coverage to encourage diabetic and pre-diabetic patients to engage more in their health care, thereby lowering costs and keeping people healthier.

The study was a joint project between Oregon Health and Science University, and the OCHIN-led ADVANCE Collaborative, the nation’s largest safety net community laboratory. OHSU researchers tracked 827,378 patients in community health centers (CHCs) nationwide using OCHIN’s and ADVANCE’s robust data set, which encompasses seven network partners with more than 4 million patient records.

Focusing on low-income pre-diabetic and diabetic patients, the research team assessed how Medicaid expansion affected diabetes management for those seen in CHCs. Lead author and assistant professor for research at OHSU, Nathalie Huguet, PhD and her team demonstrated that while overall visits for diabetic patients did not increase or significantly raise costs after Medicaid expansion, preventative screenings and follow-up care increased for the population at risk for developing diabetes. 

For low-income Americans who were previously uninsured, Medicaid expansion is an important factor in preventative care and helps patients take control of their health.

“We learned that continuous health insurance is the critical piece for previously uninsured patients to engage in preventative care,” said Huguet.

Not only does Medicaid expansion help patients, it also supports small, local CHCs dedicated to serving their communities by ensuring reimbursement. This Medicaid reimbursement plays a critical role in the financial stability of safety net clinics and is important to ongoing access for vulnerable patients, like those in this study. 

Huguet concluded, “Even a small price on pre-diabetic testing was enough to prompt patients to avoid these important tests and follow-up care, showing that the expansion made a real difference for many low-income pre-diabetics.”

Read the complete study.