COMMENTARY

Anne Peters: The Year in Diabetes

Anne L. Peters, MD; Mark Harmel, MPH

Disclosures

December 10, 2013

In This Article

How I Learned to Like Obamacare

I wasn't sure I liked the Affordable Care Act (ACA), also known as Obamacare, when I first read about it. I knew that there were many issues in healthcare policy that the law didn't address, but over time I started to pay more attention to the parts that I liked for my patients and decided that at least the law was moving in the right direction.

The most important element for people with diabetes is the elimination of discrimination on the basis of preexisting conditions.[6] Now, having diabetes no longer traps you in a job for fear of losing coverage or being stuck in high-priced, high-risk plans.

There are other benefits already in place or starting next year, including:

Young adults are able to stay on their parents' insurance plans until the age of 26 years;

A limit on out-of-pocket costs for seniors; and

Free coverage for preventive care, including yearly physical examinations.

With all the news about glitches with the Healthcare.gov Website, it is hard to remember that signing up for exchange coverage is just a small part of the ACA. The bigger insurance expansion is taking place with the increased participation in the Medicaid program -- even in the states that didn't expand their eligibility.[7] This is important for diabetes because as the Oregon experiment[8] demonstrated, access to care increases the diagnosis of diabetes and the use of preventive services.

I have patients in both East Los Angeles and on the west side signing up for the new plans, and I am working with them to help them find solutions that will provide them with the care that they need. However, I find it particularly difficult to determine what the various plans will cover in terms of devices: meters, pumps, and sensors. Still, many are relieved to have access to what seems to be affordable healthcare without paying a penalty for having a chronic illness. I am cautiously optimistic that for these individuals (who are not covered by employer-based insurance), issues will be mitigated around affording healthcare.

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