Medpagetoday.com REPORTS HERE that "health reform will increase the number of uninsured adults with diabetes who will be covered by Medicaid, researchers found. That will expand access and increase the use of healthcare in a population that has many unmet healthcare needs …."

"Medicaid plays an important role in ensuring that the relatively high and complex care needs of lower-income, nonelderly adults with diabetes are met, while keeping out-of-pocket expenses at relatively modest levels," authors wrote.

"In 2010, Medicaid covered about 60 million Americans, and in 2014 that figure will expand by about 16 million as more uninsured patients become eligible for the program as a result of the Affordable Care Act; about a million of these patients will have diabetes, the researchers said."

"At that time, Medicaid's role in financing diabetes care will grow, although little is known about the characteristics of the current adult Medicaid population with diabetes."

"To assess these characteristics, the researchers looked at data from the 2007 and 2008 Medical Expenditure Panel Survey (MEPS), restricting their analysis to low-income, nonelderly patients who were either uninsured or covered by Medicaid for a year."

"Those on Medicaid were more than twice as likely to have diabetes as those who were uninsured (10.4% versus 5%), which may be explained by the fact that the program targets those in poorer health, the researchers said."

"As expected, they wrote, those in the program who had diabetes were older than those without the condition, and more likely to be in fair or poor health or to be disabled."

"Overall, the researchers found that the total annual per-capita health spending on adult Medicaid patients with diabetes was more than three times higher than spending on beneficiaries without diabetes ($14,229 versus $4,568)."

"Yet all enrollees, regardless of diabetes status, had small out-of-pocket expenses: those without diabetes paid $155 out-of-pocket per year, while those with the condition paid $415 annually."

"The uninsured, on the other hand, were less likely to use healthcare services than patients covered by Medicaid -- although uninsured patients with diabetes did seek out healthcare more often than those without the disease, they found."

"Their per-capita expenditures were less overall ($3,498 versus $14,229) but they still paid more in out-of-pocket expenses ($1,446 versus $415) compared with diabetes patients on Medicaid."

"Uninsured diabetic adults also were more likely to report problems accessing health services and were more likely to delay care than diabetic Medicaid beneficiaries, the researchers found."

"They concluded that uninsured adults with diabetes who gain Medicaid coverage under the Affordable Care Act are likely to enter the program with unmet needs, but once enrolled, they'll have "increased utilization and improved access" to healthcare."

"In another study on Medicaid appearing in the diabetes theme issue, researchers found that states don't make use of their preferred drug lists -- catalogs of drugs that don't require prior authorization and usually represent the cheapest medications in their respective classes -- to promote safer prescribing in the wake of safety warnings."

"This suggests that state Medicaid programs may be missing 'important opportunities to promote safer, more effective prescribing ... by making full use of preferred drug lists and prior authorization,' the researchers concluded."