Study: Health Insurance Offers Inadequate Coverage for Many Patients with Diabetes

Among insured adults with diabetes in the United States, 40% struggle to pay for care, according to a recent report. That statistic increases to 60% among adults without insurance.¹

The researchers found that the average yearly out-of-pocket spending by patients with diabetes is over $1,800, and nearly a quarter of patients with diabetes say more than 10% of their family income goes toward medical expenses.¹

According to the American Diabetes Association, health care costs for Americans with diabetes are 2.3 times greater than those without diabetes. Furthermore, diagnosed diabetes costs a total of $327 billion per year.²

Researchers utilized data from the National Health Interview Survey, which was performed between 2013 and 2017, and included adults aged 64 years and older with a self-reported diagnosis of diabetes. Among the 164,696 participants, 8967 adults aged 64 or older reported having diabetes, indicating 13.1 million individuals annually across the US.¹

The mean age of the participants was 51.6 years, and 49.1% were female. When asked about their ability to pay medical bills, 41.1% said they were part of families that had financial hardships due to medical bills, and 15.6% reported an inability to pay medical bills at all.¹ In multivariate analyses, those who lacked insurance, were non-Hispanic black, had low income, or had a high-comorbidity burden were more likely to belong to families that had financial hardships.¹

When the authors compared the graded categories of financial hardship, they found a stepwise increase in the prevalence of high financial distress (70.5%), food insecurity (49.4%), cost-related nonadherence (49/5%), and foregone or delayed medical care (74%) among those unable to pay bills.¹

Individuals with diabetes mellitus were 27% more likely to have trouble affording food, 30% more likely to skip or delay checkups due to the costs, and 43% more likely to skip or delay medication refills.¹

Overall, the researchers noted that health costs due to diabetes have doubled since 2007, from $116 billion to $237 billion as of 2017. They now account for a quarter of total health care spending. While they did not investigate whether financial concerns affect health outcomes, the researchers said this provides an opportunity for further research.¹

REFERENCES

• Caraballo C, Valero-Elizondo J, Khera R, Mahajan S, et al. Burden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States. Circulation: Cardiovascular Quality and Outcomes. https://www.ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.119.006139. Accessed March 4, 2020.
• The Cost of Diabetes, American Diabetes Association. https://www.diabetes.org/resources/statistics/cost-diabetes. Accessed March 19, 2020.