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Medicaid Expansion Linked to Earlier Diagnosis and Treatment of Diabetes

By Andrea Callow,


New research suggests that the expansion of Medicaid under the Affordable Care Act is linked to better diagnosis of one of America’s most lethal and costly diseases: diabetes. In a study published last week by Diabetes Care: The Journal of the American Diabetes Association, researchers from the medical testing company Quest Diagnostics and Tulane University found a dramatic increase in the number of Medicaid patients with newly diagnosed diabetes in states that expanded Medicaid.

In the study, researchers culled all cases of newly identified diabetes from all 50 states in the Quest database, the largest private clinical laboratory database in the nation. They looked at information from several hundred thousand patients over two six-month periods: one six-month control period in 2013, and six months after Medicaid expansion took effect in 2014.

Much higher rate of new diabetes diagnoses in states that expanded Medicaid

Researchers found that:

  • in the 26 states that expanded Medicaid, the number of Medicaid patients with newly identified diabetes rose by 23 percent in the first six months of 2014 from the same period in 2013.
  • in states that did not expand Medicaid, the diagnoses rose by only 0.4 percent during the same time period.

One notable finding pertained to patients between the ages of 50 and 64, for whom complications related to undiagnosed diabetes can be particularly dangerous. Those who lived in expansion states made up the largest increase in new diabetes cases, 31 percent. In non-expansion states, there was an increase of only 0.5 percent among patients in the same age group.

These data strongly suggest that Medicaid expansion increases access to necessary diabetes testing, allowing significantly more affected individuals to get diagnosed and treated for the disease. 

When undetected and untreated, diabetes harms health and productivity

Diabetes is the seventh leading cause of death in the United States and a major source of disability, with currently one in 10 Americans diagnosed with the disease. Diabetes can take a serious toll on health and productivity if left undetected and untreated. The disease can lead to kidney damage, requiring transplantation and dialysis, stroke, heart attack, blindness, as well as leg and foot amputations. The Centers for Disease Control estimates that diabetes costs the United States nearly $245 billion dollars per year in medical expenses and decreased worker productivity. However, if diabetes is caught and treated early, outcomes can be improved and costly, disabling complications diminished or avoided.

Prevalence of diabetes overlaps with many non-expansion states

Diabetes is especially prevalent in the southern United States. Fifteen states form an area experts have labeled the “diabetes belt,” where disease prevalence is much higher than the national average. Nine of these diabetes belt states—Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, Tennessee, Texas, and Virginia—have not expanded Medicaid. Their residents and economies have much to gain from Medicaid expansion.

Diabetes is a disease that can be managed if caught early and treated. Without proper diagnosis and treatment, it leads to disability and premature death. New data make clear that Medicaid expansion allows greater access to diabetes testing for low-income individuals. State leaders should vote to make access to life-saving care available to hundreds of thousands of their citizens.