Association of Diabetes Care & Education Specialists

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Impact of the Affordable Care Act on Diabetes Educators

May 26, 2015

Last week, the Supreme Court decided to uphold the Affordable Care Act (ACA), which will be fully implemented in 2014.

What it means for persons with diabetes:
1. Insurance companies will no longer be allowed to deny coverage due to a pre-existing condition such as diabetes.
2. Young adults will be able to remain on their parent's insurance until the age of 26.
3. Lifetime limits on health insurance coverage will be eliminated and access to preventative care will be increased.

What it means for healthcare professionals:
1. The level of diabetes medical education that should be required prior to licensure, board certification and board recertification will be examined. 
2. A national diabetes prevention program targeted to adults at high risk for diabetes will be established to eliminate the preventable burden of diabetes.
3. Effective January 1, 2015, physicians will be paid based on quality of care (value) and not volume.  Those who provide higher care value will receive higher payments than those who provide lower quality care.

The ACA is without doubt a major change in our health care system that comes with many unanswered questions and concerns, such as the impact on taxes.  However, the ACA will generate new roles and opportunities for diabetes educators.  As the number of uninsured individuals who gain access to the health care system increases, diabetes educators will be needed to provide the education and management skills required.  It is crucial that educators become familiar with the law to ensure our organization is part of the dialogue and implementation of this momentous part of our history.  I encourage you to visit the website to become more informed http://www.healthcare.gov/law/index.html

What are your thoughts about the ACA?  What do you think the role of the diabetes educators will be?

5 comments

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  1. Aug 02, 2012

    I am looking forward to seeing the effect of the ACA, especially the prevention programs. What will be the buy-in for someone to manage their diabetes? How will that work, I wonder?
  2. Jul 10, 2012

    Taxes are going to go up. One of the ways that the ACA will be paid for is through a 3.8% sales tax when a person sells a property. Put that on top of what one needs to pay the real estate agent and any capital gains tax. There are most likely other "hidden" and unintended consequences that will be found in time. Another problem is the lack of competition between insurance companies. Some states are virtually monopolized by one insurance company. Presently, it is my understanding that a person can not shop for insurance across state lines. Where is our "free" market? Competition is-- most of the time-- in favor of the consumer. The ACA sounds great - time will tell if it is practical in its present form.
  3. Jul 09, 2012

    The ACA ensures health plans offered in the individual and small group markets, both inside and outside of the Affordable Insurance Exchanges (Exchanges), offer a comprehensive package of items and services, known as essential health benefits. Essential health benefits (EHB) must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care. Insurance policies must cover these benefits in order to be certified and offered in Exchanges, and all Medicaid state plans must cover these services by 2014. As the EHB is rolled out, the power to determine who the qualified providers of these services are will be given to the states. They will base it on the provider’s license and legal scope of practice. Currently there is no legal scope of practice (or license) for the diabetes educator. The new regulations stemming from the ACA and EHB should expedite the need for states to seriously consider pursuing licensure as a means to meet the demand for qualified diabetes educators, combat the growing prevalence of diabetes, and protect the profession and practice of diabetes education. advocacy@aadenet.org
  4. Jul 06, 2012

    How will this impact move towards licensure for DEs?
  5. Jul 05, 2012

    I do think it sounds great on the surface and the potentials look great on the surface....but ...because the plan was not realistically though out and funded,then was expediated for political purposes, there will be many unintended problems and consequences. - I CAUTION TO "WAIT AND SEE HOW THIS PANS OUT BEFORE DRAWING CONCLUSIONS" Funding for all this has to come from somewhere and the cost of this was "hidden" from the citizens and employers for political purposes to make political points. These things are worthy of working on but do it realistic methods. With most of that funding coming from increasing taxes on employers and those who do have insurance coverage through employment, the cost of covering employee's will dramatically increase and WILL CAUSE MANY WHO DO HAVE INSURANCE COVERAGE TO LOOSE IT. I am already seeing this happen to the "contract" medical assistants and case managers where I work.. THEY HAVE LOST BENEFIT COVERAGE AS OF THIS MONTH! We just found out two days ago. This is only the begining I'm sure. I suspect you will begin to see and hear of this dramatically over the next year or two unless this is re- thought and changes are made. I am seriously worried. It will mean choices and options will dry up! The private sector will begin to drop health care benefits and the government doesn't have the funds to "pick-up or maintain the previous levels of coverages for uninsured and many newly uninsured as well as and add on new coverages. Taxes will be massive for employers and private citizens. It was a pie in the sky dream and I do think we need to do better! It is just too early to give anything a yeah or nay as far as I'm concerned. But I am worried.

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