Losing health insurance is dangerous for anyone. For people with diabetes, however, the consequences arrive faster and hit harder. A new study from Oregon Health & Science University (OHSU) confirms what many healthcare workers already suspect — insurance loss worsens diabetes outcomes quickly. Moreover, the findings come at a critical moment, as millions of low-income Americans face potential Medicaid cuts in 2026.
Why Insurance Loss Threatens Diabetes Patients
Diabetes requires consistent, ongoing management. Patients need regular check-ups, blood sugar monitoring, and often complex medication regimens. Therefore, any disruption in health coverage directly disrupts care. Unlike many other conditions, diabetes does not pause while a patient waits to regain insurance.
Low-income adults already face more barriers to care. Community health centers serve this population and rely heavily on Medicaid funding. Consequently, any large-scale reduction in Medicaid threatens both patients and the clinics they depend on.
What the OHSU Study Found
Published in JAMA Health Forum
Researchers at OHSU analyzed electronic health records from more than 39,000 adults. These patients received care at safety-net community health centers across 20 states. The study, published in JAMA Health Forum, focused on adults who experienced insurance “churn” — defined as losing coverage for multiple medical visits.
The results were clear. Low-income adults with diabetes who lost coverage showed:
- Poorer blood sugar control compared to insured peers
- A greater need for more intensive medications
- Higher risk of complications that require emergency care
Furthermore, all patients in the study started at the same health baseline. Even so, those who lost insurance fell behind quickly.
Who Faces the Highest Risk
Complexity Increases Vulnerability
Not all diabetes patients face equal risk. The OHSU research identified specific groups most vulnerable to insurance loss. Patients with more complex medication regimens face greater instability. Similarly, those already experiencing diabetes complications suffer disproportionately when coverage ends.
Additionally, a related OHSU study found that low-income adults with diabetes are 25% more likely to experience insurance instability than people without diabetes. Among those who lose Medicaid, 46% never regain health coverage. Among those who lose private insurance, the figure rises to 61%.
These numbers reveal a harsh reality. Most people who lose coverage do not simply transition to another plan. Instead, they go without insurance for long stretches — or permanently.
Blood Sugar Control Worsens Fast After Coverage Loss
The Real Cost of Coverage Gaps
Lead researcher Nathalie Huguet, Ph.D., an associate professor of family medicine at OHSU, explained the core finding plainly. People with diabetes who lose insurance are more likely to have complications. Those complications can be life-changing — and often are.
Without insurance, patients struggle to afford insulin, testing supplies, and specialist visits. Consequently, blood sugar levels rise. Over time, uncontrolled diabetes damages kidneys, nerves, and eyes. Moreover, it raises the risk of cardiovascular disease and limb amputations. These are not abstract risks. They are outcomes that play out in emergency rooms and operating theaters every day.
The Emergency Department Burden
A Costlier Outcome for Everyone
When diabetes spirals out of control, patients often end up in emergency departments. This pattern creates serious consequences — not just for patients, but for the entire health system.
Emergency care for advanced diabetes complications costs far more than ongoing primary care management. Furthermore, uninsured patients frequently cannot pay those bills. Huguet noted that unmanaged diabetes leads to outcomes like amputations — events that are both devastating and expensive. In the end, cutting Medicaid does not save money. Instead, it shifts costs to emergency systems already under pressure.
Medicaid Cuts Loom as Timing Turns Critical
Millions at Risk in 2026
The OHSU findings arrive at a particularly urgent moment. Congressional Republicans are advancing proposals that would significantly reduce Medicaid enrollment. Analysts project that millions of Americans could lose coverage. In Oregon alone, 63% of adult Medicaid enrollees could risk losing coverage under certain proposed policies.
Huguet noted that marketplace health plans are expensive alternatives. Insulin alone remains unaffordable for many people without insurance. Therefore, the assumption that displaced Medicaid enrollees will simply find other coverage is not supported by evidence. The data shows clearly that most do not.
What Community Health Centers Need Now
Protecting the Safety Net
Community health centers already provide discounted medications and care to low-income patients. However, they depend heavily on Medicaid funding to do so. Co-author Jennifer DeVoe, M.D., D.Phil., a professor of family medicine at OHSU, stated the challenge directly — if Medicaid shrinks, clinics will struggle to care for these patients.
DeVoe called for increased support for primary care clinics. The goal is to limit the harm caused by coverage loss and keep patients connected to care. Without this investment, the downstream costs — in human suffering and healthcare spending — will grow substantially.
Conclusion: Keeping People Insured Must Be the Priority
The OHSU study delivers an urgent message. Insurance loss harms people with diabetes quickly and deeply. Furthermore, most who lose coverage never get it back. As Medicaid cuts approach, the data demands a clear response from policymakers.
Huguet put it directly — diabetes is costly, and keeping people insured should be the priority. Finding ways to reduce coverage is not a solution. Above all, the evidence shows that protecting Medicaid protects lives, reduces emergency costs, and preserves a healthcare safety net that millions of Americans cannot afford to lose.
