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System Shuts Out Diabetics

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NU Online News Service, Feb. 8, 2005, 2:45 p.m. EST

Some of the U.S. residents who need health coverage most have the hardest time getting it.[@@]

The American Diabetes Association, Alexandria, Va., has helped to release an analysis of coverage-access problems based on a study of diabetes association activities conducted by researchers at Georgetown University.

The researchers analyzed information about 851 people with diabetes who called the diabetes association for help with health insurance problems.

Only 40% of the diabetics who called had health coverage, and half of those diabetics were about to lose their coverage, the researchers found.

The diabetes association was able to help 20% of the callers get health coverage, but it found that no source of coverage was available for 20% of the callers. In 60% of the cases, callers were eligible for help under some kind of law or program, but the help turned out to be inadequate to solve the callers’ problems, according to the researchers.

Some states, for example, offer residents with diabetes access to “risk pools,” or coverage arrangements for residents with a high risk for needing medical care, that are expensive, impose strict limits on coverage for pre-existing conditions and may saddle patients with high out-of-pocket costs, the researchers found.

The researchers found that one risk pool, in Arkansas, had a low-cost coverage option that could lead to some plan members making up to $20,000 in deductible payments and coinsurance payments.


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