Type 1 Diabetes and Insurance Concerns
Managing a chronic illness can be expensive, and Type 1 diabetes is certainly no exception. As we near the implementation of the Affordable Care Act (ACA), otherwise known as "ObamaCare," families and their healthcare providers share the same concerns about how the new legislation will affect diabetes management.
An article in the Washington Post Health and Science section published on June 18, 2013 caught my eye, "A child with diabetes, a quarter- century later," in which a parent chronicled diabetes care over 25 years after initially diagnosed with Type 1 diabetes at age 10 months. According to Lenny Bernstein, the father and author of this article, the young lady, under the ACA, has been able to remain on the family's health insurance until 26 years of age. Having reached this milestone, she will no longer be covered. He noted that the health system served his daughter well for the 25 years and responded to most of her needs. At present, his daughter has her own insurance and under the ACA she can't be excluded because of her preexisting condition, which was not always the case before the Affordable Care Act (ACA). In addition, the author notes that "Anyone who questions the benefit of mandatory health insurance hasn't stood where I have: in an emergency room with a clutch of worried doctors trying to figure out why our infant was slipping in and out of consciousness. No one ever expects to be in the ER or intensive care unit. But it happens, and it’s very expensive."
The author of the article also quoted information (Diabetes, 2012) that I wrote about in a previous post. The life expectancy at birth for a child diagnosed with T1DM between 1965 and 1980 was 68.8 years. Of course, this was before all the advances of research including intensive insulin therapy, sophisticated equipment such as blood glucose meters, insulin pumps, and continuous glucose sensors. Today, children who contract diabetes can expect a normal life span IF they manage their diabetes carefully.
Before the ACA, children often lost their insurance when they graduated from high school or college. As I have written in previous posts, when emerging adults transition to adult care providers or are removed from the family's health insurance, they often do not receive routine follow-up for their chronic illness which may result in acute and perhaps later complications. It is also important to realize that based on the ACA, emerging adults cannot be denied insurance because of preexisting diabetes. This is extremely significant and should be a great relief to family caregivers and healthcare providers who do not want to have to make choices of treatment based solely on health insurance.
The near future will determine the success of the ACA and the ramifications for children, adolescents, and emerging adults with chronic illnesses such as diabetes. All healthcare providers are hopeful that health insurance will continue to provide most of the coverage for this very expensive disease. Coverage is important, especially as we rely on even more costly technology to improve management, strive to avoid complications, and ultimately achieve lifetime savings in healthcare costs for these patients in the future.