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A recent study led by researchers at Oregon Health & Science University has revealed that adults with diabetes from low-income backgrounds face a higher likelihood of experiencing health insurance instability. This instability is particularly pronounced among individuals with more complex health needs.
Published in the Journal of American Family Medicine, the research analyzed electronic health records from over 300,000 adults aged 19 to 64 who received care at community health centers between 2014 and 2019. The findings indicated that approximately 39,500 individuals lost their health insurance during this period.
The researchers employed statistical models to assess the likelihood of insurance loss among these patients. The results showed that individuals diagnosed with diabetes were 25% more likely to lose their health insurance compared to those without the condition. Furthermore, among patients with diabetes, those who had uncontrolled blood sugar levels, required complex medication regimens, or experienced complications were even more susceptible to losing their coverage.
One of the study's authors expressed surprise at the findings, noting that the expectation was that individuals with diabetes would be more proactive in maintaining their health insurance due to their medical needs. The researchers defined insurance instability, also referred to as "churn," as a situation where a previously insured patient has at least two consecutive visits to a clinician without having insurance.
Concerningly, the study indicated that a significant proportion of patients did not regain their health insurance after losing it. Specifically, 46% of diabetic patients who lost their Medicaid coverage were unlikely to regain insurance, and 61% of those who lost private insurance never returned to having coverage.
This finding challenges previous assumptions regarding the re-enrollment of individuals who lose insurance eligibility. The study highlights the critical situation that many individuals face, particularly following the mass disenrollment of approximately 25 million people from Medicaid in May 2023, which occurred at the conclusion of the public health emergency related to the pandemic. Policymakers had anticipated that a majority of those disenrolled would successfully obtain alternative insurance.
Although the data analyzed in this study concluded in 2019, researchers are planning to investigate the outcomes for individuals disenrolled after the pandemic. There is growing concern that those with the most pressing healthcare needs, including diabetes and other complex medical conditions, are disproportionately affected by the loss of health insurance.
The researchers urge policymakers to implement strategies that ensure individuals remain enrolled in insurance programs. In cases where disenrollment does occur, they advocate for direct assistance in navigating the process to secure alternative insurance options. They stress the importance of a more gradual disenrollment process, coupled with support mechanisms to help individuals transition to new coverage, rather than a sudden mass disenrollment.
Some states, such as Oregon, have managed to avoid disenrolling individuals post-pandemic. Experts emphasize that maintaining insurance coverage is vital for controlling overall healthcare costs and reducing emergency room visits.
For more detailed information, the full study can be accessed in the Journal of American Family Medicine.
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