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Evaluating the impact of the Medicaid expansion program on diabetes hospitalization

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Abstract

Diabetes is the most expensive chronic disease in the United States, and hospital inpatient care accounts for 30% of the total medical expenditures. Medical costs for people with limited resources are covered by Medicaid, a joint federal and state program, and its expansion that extent the coverage to those with incomes up to 138% of the federal poverty level. We investigated the impact of Medicaid expansion on diabetes hospitalizations by states and payer, among adults aged 19 to 64 years old, 5 years after the expansion. We found that Medicaid expansion decreased total diabetes hospitalization in most states and a diabetes hospitalization payer mix shifted from private insurance and uninsured to Medicaid. The percentage of diabetes hospitalizations paid by Medicaid increased by 11% (95% CI 7%, 16%), while the percentage paid by private insurance decreased by 6% (95% CI − 8%, − 3%) and the percentage of uninsured diabetes hospitalization decreased by 13% (95% CI − 18%, − 9%).

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Funding

This study was supported by National Institute on Minority Health and Health Disparities.

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  1. Department of Epidemiology, University of California, Los Angeles (UCLA) Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA

    Fan Zhao & Roch A. Nianogo

  2. California Center for Population Research (CCPR), Los Angeles, CA, USA

    Roch A. Nianogo

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  1. Fan Zhao
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Correspondence to Fan Zhao.

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Zhao, F., Nianogo, R.A. Evaluating the impact of the Medicaid expansion program on diabetes hospitalization. J Public Health Pol 45, 86–99 (2024). https://doi.org/10.1057/s41271-023-00463-0

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