ACA Improved Quality of Life for Diabetes Patients

After implementation of the Affordable Care Act, health related quality of life was higher among adult patients with type 2 diabetes, according to a presentation at the American Diabetes Association’s 77th Scientific Sessions.

“Several programs were implemented under the Affordable Care Act (ACA) to improve diabetes management and outcomes, including Medicaid expansion benefits to individuals below/at 138% of the federal poverty level,” Lorinette S Wirth, MPH, a health economics and outcomes research assistant at the College for Public Health and Social Justice at the Saint Louis University, and colleagues wrote. “We aimed to evaluate the impact of the ACA on the health-related quality of life of adults reporting diabetes.”

The researchers examined a nationally representative sample of patients aged 19 to 64 years. They compared 1501 patients’ health-related quality of life scores from before implementation of the ACA to scores for 1607 patients after ACA implementation. Physical health component scale (PCS-12) and mental health component scale (MCS-12) scores were extracted using the Medical Expenditure Panel Survey from 2009 to 2014.

Study results showed that diabetes prevalence was higher in the ACA cohort (6.1% vs 6.9%). Additionally, PCS-12 scores and MCS-12 scores were lower among diabetes patients in both cohorts. However, PCS-12 scores were 4.17 points higher among patients with diabetes during the ACA years, but only for patients below 138% of the federal poverty level.

Ms Wirth and colleagues found no statistically significant difference in mental health scores between the two study groups.

The researchers noted that the higher quality of life scores suggested that the ACA had a significant impact on diabetes management; however, they stressed that lawmakers need to take mental health concerns into consideration when planning new major health care legislation.

“Higher health-related quality of life for the within-ACA cohort suggests that the ACA was effective in improving diabetes outcomes for individuals under/at the 138% federal poverty level; however, mental health improvements continue to lag,” Ms Wirth and colleagues concluded. “Policy makers should consider these strengths and weaknesses when applying macro level changes.” —David Costill