Mary A M Rogers1, Catherine Kim1, Joyce M Lee1, Tanima Basu1, Renuka Tipirneni1. 1. Mary A. M. Rogers, Catherine Kim, and Renuka Tipirneni are with the Department of Internal Medicine and the Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor. Tanima Basu is with the Institute of Healthcare Policy and Innovation, University of Michigan. Joyce M. Lee is with the Institute of Healthcare Policy and Innovation and the Department of Pediatrics and Communicable Diseases, University of Michigan.
Abstract
OBJECTIVES: To examine private insurance coverage for persons with diabetes before and after enactment of the preexisting condition mandate of the Affordable Care Act (ACA) in the United States. METHODS: We conducted a nationwide study in adults aged 20 to 59 years with private health insurance with the Clinformatics Data Mart Database (2005-2016). We used fixed-effects negative binomial regression to evaluate differences in pre-post mandate trends. RESULTS: There was a 4% decline in prevalence rates of type 1 diabetes in adults with private health insurance before the mandate and an 11% increase afterward (P < .001). Coverage increased to the greatest extent (-6% before, +20% after) in those aged 50 to 59 years (P < .001). For type 2 diabetes, there was a significant decline in prevalence before the mandate, which increased afterward in those aged 40 to 49 years (-4% before, 3% after; P = .031) and 50 to 59 years (-6% before, 15% after; P < .001). CONCLUSIONS: Adults with diabetes may have benefited in obtaining private health insurance after implementation of the preexisting condition mandate of the ACA. Public Health Implications. Efforts to limit enforcement of these protections are likely to contribute to setbacks in access to care.
OBJECTIVES: To examine private insurance coverage for persons with diabetes before and after enactment of the preexisting condition mandate of the Affordable Care Act (ACA) in the United States. METHODS: We conducted a nationwide study in adults aged 20 to 59 years with private health insurance with the Clinformatics Data Mart Database (2005-2016). We used fixed-effects negative binomial regression to evaluate differences in pre-post mandate trends. RESULTS: There was a 4% decline in prevalence rates of type 1 diabetes in adults with private health insurance before the mandate and an 11% increase afterward (P < .001). Coverage increased to the greatest extent (-6% before, +20% after) in those aged 50 to 59 years (P < .001). For type 2 diabetes, there was a significant decline in prevalence before the mandate, which increased afterward in those aged 40 to 49 years (-4% before, 3% after; P = .031) and 50 to 59 years (-6% before, 15% after; P < .001). CONCLUSIONS: Adults with diabetes may have benefited in obtaining private health insurance after implementation of the preexisting condition mandate of the ACA. Public Health Implications. Efforts to limit enforcement of these protections are likely to contribute to setbacks in access to care.
Authors: Nancy E Kass; Amy M Medley; Marvin R Natowicz; Sara Chandros Hull; Ruth R Faden; Laura Plantinga; Lawrence O Gostin Journal: Am J Med Genet A Date: 2007-04-01 Impact factor: 2.802
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