Medicaid Eligibility Expansions May Address Gaps In Access To Diabetes Medications.

Myerson R1, Lu T2, Tonnu-Mihara I3, Huang ES4.

Author information

1: Rebecca Myerson ( rmyerson@healthpolicy.usc.edu ) is an assistant professor of pharmaceutical and health economics at the School of Pharmacy and the Leonard D. Schaeffer Center for Health Policy and Economics, both at the University of Southern California, in Los Angeles.
2: Tianyi Lu is a PhD student in the School of Pharmacy and the Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California.
3: Ivy Tonnu-Mihara is a director of program analytics and research for the Pharmacy Service, Veterans Affairs (VA) Long Beach Healthcare System, in Long Beach, California; and a pharmacist consultant for the Veterans Health Administration, Office of Academic Affiliations, in Washington, D.C.
4: Elbert S. Huang is a professor of medicine and director of the Center for Chronic Disease Research and Policy at the University of Chicago.

Abstract

Diabetes is a top contributor to the avoidable burden of disease. Costly diabetes medications, including insulin and drugs from newer medication classes, can be inaccessible to people who lack insurance coverage. In 2014 and 2015 twenty-nine states and the District of Columbia expanded eligibility for Medicaid among low-income adults. To examine the impacts of Medicaid expansion on access to diabetes medications, we analyzed data on over ninety-six million prescription fills using Medicaid insurance in the period January 2008-December 2015. Medicaid eligibility expansions were associated with thirty additional Medicaid diabetes prescriptions filled per 1,000 population in 2014-15, relative to states that did not expand Medicaid eligibility. Age groups with higher prevalence of diabetes exhibited larger increases. The increase in prescription fills grew significantly over time. Overall, fills for insulin and for newer medications increased by 40 percent and 39 percent, respectively. Our findings suggest that Medicaid eligibility expansions may address gaps in access to diabetes medications, with increasing effects over time.