The 130th Annual Meeting of APHA

4247.0: Tuesday, November 12, 2002 - 4:45 PM

Abstract #48930

Low-income uninsured diabetics and state Medicaid programs

Robert L. Williams, MD, MPH, Family and Community Medicine, University of New Mexico, 2400 Tucker Ave. NE, Albuquerque, NM 87131, 505-272-2165, rlwilliams@salud.unm.edu, Michael Schillaci, PhD candidate, Department of Family and Community Medicine, University of New Mexico, 2400 Tucker Ave NE, Albuquerque, NM 87131, Howard Waitzkin, MD, PhD, Masters in Public Health Program, University of New Mexico, 2400 Tucker N.E., School of Medicine, Albuquerque, NM 87131, and Richard Santos, PhD, Department of Economics, University of New Mexico, Main Campus, Albuquerque, NM 87131.

Low-income, uninsured persons with chronic illness are health and financial time-bombs. Because they often cannot afford preventive and primary care, they are more likely to develop serious and costly complications of their illnesses. In many cases, local and state governments carry the ultimate financial burden for these complications. The objective of this study was to explore the costs and benefits of including one class of such persons in state Medicaid programs. In a state-wide, random digit dialed telephone survey of low-income persons in New Mexico, persons identified as diabetics were asked a variety of questions about their health, health care utilization and willingness to pay a monthly premium to be included in a state insurance program for low-income diabetics. Of 1216 respondents to the survey, 116 (9.5%) were diabetic. Compared with insured diabetics, uninsured diabetics were more likely to have not taken all of their medicines due to cost. Uninsured diabetics were significantly more likely to have not had recommended eye exams and to have been hospitalized. Most low-income uninsured diabetics were able and willing to pay a monthly premium to be included in state coverage for their diabetes. When combined with data on costs of complications from diabetes obtained from the literature, this suggests that it may be cost efficient for states to consider such a program. By including low-income persons at high risk for developing costly complications in Medicaid programs, states may reduce their ultimate financial burden.

Learning Objectives:

  • At the conclusion of the session, the participant (learner) in this session will be able to

    Keywords: Low-Income, Diabetes

    Presenting author's disclosure statement:
    I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

    Developing Programs and Policies to Serve the Uninsured

    The 130th Annual Meeting of APHA