Diabetes Advocates Oppose Affordable Care Act Replacement

The American Diabetes Association (ADA) recently sent a letter to Congress over concerns regarding the proposed replacement plan for the Affordable Care Act (ACA). The association believes that the American Health Care Act (AHCA) could negatively impact the 116 million Americans living with, and at risk for diabetes, according to a press release.

"On behalf of the nearly 30 million Americans living with diabetes and the 86 million more with prediabetes, the Association expresses our serious concerns with the American Health Care Act and the impact it will have for people with, and at risk for, diabetes,” William T. Cefalu, MD, chief scientific, medical & mission officer at ADA, wrote in the letter.

Previously, the ADA voiced concerns over repealing the ACA without immediately replacing it with a law that would preserve coverage for patients with diabetes.

Despite keeping the pre-existing conditions provision, the AHCA could still affect patients with diabetes, and the ADA has reservations about the proposed law, according to the letter.

The ADA cited major concerns with the replacement bill, including tax credits, Medicaid changes, the continuous coverage penalty, and potential funding cuts for diabetes prevention programs. However, until the Congressional Budget Office releases their report regarding the AHCA, the full scope of coverage and costs remain unknown.

Under the AHCA, financial assistance for purchasing insurance would be significantly reduced, especially for low and middle income patients. Although the proposal could lower premiums for younger healthy individuals, it will likely raise costs for older patients with chronic conditions, such as diabetes.

“In addition, the changes proposed to Medicaid are particularly alarming and could have a drastically negative impact on low-income individuals and families affected by diabetes,” Dr Cefalu wrote. “Adults with diabetes are disproportionately covered by Medicaid.”

Additionally, there have been increases in diabetes screenings and diagnoses among states that expanded their Medicaid programs. Changes in funding could lead to lower rates of both, which could result in advanced disease progression and complications. The ADA also opposes the proposed changes to the Medicaid financing structure.

The proposed replacement plan should make sure that patients are able to receive continuous coverage, regardless of their circumstances, according to the letter. However, implementing the continuous coverage premium penalty, which would add a surcharge of 30% for those who lose coverage, does not take financial concerns into account. The ADA argues that not all patients choose to become uninsured, but some simply cannot afford coverage.

Diabetes and related complications are able to be managed with proper education and initiatives. Type 2 diabetes can often be prevented if patients are able to access affordable insurance, according to the letter.

The ADA advocates for research, therapeutic interventions, and access to care for patients with diabetes and at risk for the condition. If the ACA is not replaced by legislation that amends the aforementioned concerns, there will likely be serious health consequences for patients with diabetes and other serious conditions, the letter warned.

“As always, we will continue to join forces with our fellow patient advocates and strategic partners to ensure access to quality care for those who need it, and we will continue to fight tirelessly to improve the lives of all people affected by diabetes,” Cefalu concluded.