500,000 Patients With Diabetes May Lose Healthcare Under New Medicaid Legislation

Roughly 500,000 Medicaid beneficiaries with diabetes are predicted to lose healthcare coverage by 2034, according to a recent study from the American Diabetes Association (ADA).1,2

According to the National Diabetes Statistics Report, released by the US Centers for Disease Control and Prevention (CDC), >40 million Americans have diabetes – of these, >29 million adults and children have a confirmed diabetes diagnosis. Roughly 6 million Americans with this diagnosis are enrolled in Medicaid, representing nearly 11% of the country’s total diabetes population. Additionally, approximately 1.7 million patients with diabetes are enrolled in an individual market plan via the Affordable Care Act (ACA).1

However, in July 2025, Congress passed H.R. 1 legislation, which brought about significant changes to federal healthcare coverage through Medicaid. These policies are expected to reduce Medicaid enrollment by around 7 million beneficiaries by 2034. The document itself limits provider taxes states use to fund Medicaid programs, as well as increasing eligibility verification requirements and cost-sharing obligations for certain enrollees. Coupled with existing regulations, this legislation may revoke coverage for between 8 and 12 million patients in individual market plans.1

“The extreme loss of healthcare coverage we’re anticipating among the diabetes population as a result of recent changes to the Medicaid program will have a devastating impact on people with diabetes and lasting repercussions across the US healthcare system—driven by increased hospitalizations, complications from diabetes, and emergency room care,” Lisa Murdock, chief advocacy officer of the ADA, said in a statement.2

For the present study, the ADA commissioned research from Health Management Associates (HMA) to determine the scale of individual market coverage losses and new costs for Medicaid and ACA healthcare for patients with diabetes after the enactment of H.R. 1. Using Congressional Budget Office analysis and Medicaid enrollment and claims data, among other data sources, the ADA ultimately confirmed that, without further policy change, almost 500,000 Medicaid beneficiaries with diabetes will lose coverage by 2034.1

The largest contributor to this reduction will be changes to state provider taxes, accounting for nearly 45% of projected disenrollments. Policies limiting erroneous payments (16%), more routine eligibility assessments (16%), and retroactive enrollment (12%) will also account for coverage losses over this period. Additionally, these data indicate that most patients who will lose their Medicaid coverage live in states that previously expanded their Medicaid programs under the ACA, accounting for 93% of projected disenrollments.1

Of the patients who remain covered and enrolled in Medicaid, 1.5 million could have new cost-sharing obligations by 2029 – patients with diabetes could pay up to $1000 more annually for their health expenses. Additionally, 654,000 patients enrolled in ACA individual market plans are expected to lose coverage between 2025 and 2027, representing between 24% and 39% of all patients with diabetes who have ACA plans.1

The ADA cites data from JAMA Health Forum stating that patients with low incomes who lack consistent healthcare coverage see poorer blood glucose management and need more medications, such as insulin, for long-term disease management compared to patients who do not regularly experience lapses in coverage. The resulting worse health outcomes could increase the likelihood of unnecessary hospitalizations. Therefore, the study concludes that limiting or eliminating coverage for some of the more vulnerable patients with diabetes could put a major burden on the US healthcare system, as well as patients with diabetes and their families.1

“For half a million people with diabetes, losing access to Medicaid means losing access to healthcare professionals, diabetes education and management, affordable insulin, and technology critical to blood glucose management directly affecting their health,” Murdock said.2

References

1. American Diabetes Association. Impact of Recent Medicaid and Affordable Care Act Policy Changes on Health Insurance Coverage and Cost-Sharing for Americans with Diabetes. August 3, 2026. Accessed August 6, 2026. https://diabetes.org/sites/default/files/2026-07/Affordable%20Care%20White%20Paper%20FINAL.pdf

2. American Diabetes Association. New Study: 500,000 Americans with Diabetes Projected to Lose Medicaid Coverage by 2034. PR Newswire. August 3, 2026. Accessed August 6, 2026. https://www.prnewswire.com/news-releases/new-study-500-000-americans-with-diabetes-projected-to-lose-medicaid-coverage-by-2034--302840319.html