Did the Affordable Care Act's Medicaid Expansion Save Lives? We estimate the impact of the Affordable Care Act's Medicaid expansion on county-level mortality in the first four years after the expansion. We discover a drop in all-cause mortality in people aged 20 to 64, equaling 11.36 deaths per 100,000 people, a 3.6 percent decrease. This implies that extending insurance to more than 9 million Americans will save lives.
The findings are based on an analysis of how counties performed before and after they decided to participate in the Medicaid expansion. Before the expansion, 33 states plus the District of Columbia had implemented some form of coverage for low-income residents; after the expansion, only 14 remain so. Using data from the Centers for Disease Control and Prevention, we compare changes in mortality between counties that chose to expand Medicaid and those that did not. Our results indicate that if all counties had participated in the expansion, there would have been an additional 52,000 deaths over the study period.
We also examine whether mortality changed differently for different population groups. There were significant decreases in mortality for whites, blacks, and Hispanics, but not for Asians or children under the age of 19. The largest reduction was seen among whites, who would have experienced 13.92 fewer deaths per 100,000 people if all counties had participated in the expansion.
Finally, we look at what is known as the "time-series" approach to understanding how health care reforms affect mortality.
"The lifesaving effects of Medicaid expansion are significant, with a projected 39 to 64 percent reduction in yearly death rates for older persons who obtain coverage." According to a groundbreaking research, the Affordable Care Act's (ACA) extension of Medicaid to low-income individuals saves thousands of lives each year. The study, which was published in the Journal of the American Medical Association (JAMA), concluded that if all states had expanded their programs as planned, over 50,000 people would not have died in 2007-2008 alone. The researchers estimated that if all states had implemented the policy change as intended, 740,000 people would be alive today.
Medicaid is government health insurance for low-income individuals and families. Before the ACA, most states opted out of the program altogether, so the only option for many poor people was to go without medical care or pay for it out of pocket. Through Medicaid, low-income adults aged 19-64 can now be covered by a state plan, including children and pregnant women. The federal government provides funding for states that choose to participate in Medicaid.
In addition to extending health insurance to millions of Americans, the ACA includes incentives for states to improve their own health care systems by allowing certain types of changes to their infrastructure or programs to receive federal funds. As a result, several states have moved forward with Medicaid reforms designed to improve access to care or reduce costs.
The expansion of Medicaid to include nearly 17 million more Americans was a crucial component of the 2010 Affordable Care Act (ACA). 1. Despite the fact that this makes budgetary sense, conservative lawmakers have vehemently resisted it. Medicaid expansion has been flatly denied in numerous Republican-led states.
According to an August report from the Kaiser Family Foundation, "all 50 state legislatures are in session, which means all members of Congress and every other governor in the country are available for questioning on this issue." Not one single Republican senator or representative has supported Medicaid expansion. In fact, as of early September, not a single Republican had signed on as a co-sponsor of legislation to provide federal funds for states that want to expand their programs.
Even if they were to support it now, there is no guarantee that future Republican governors and legislators would continue to do so. As we've seen with previous efforts to repeal parts of Obamacare, if there's no funding attached to it then it can't be done through legislative action -- only through executive orders or budget cuts.
Thus, it appears that even if Republicans support Medicaid expansion, they can't get anything done about it.
Since the ACA's biggest coverage expansions went into effect in 2014, Medicaid has contributed to a reduction in the number of uninsured people from 45 million to 29 million. Most of the tens of millions of Medicaid members would be uninsured if Medicaid did not exist.
The ACA required that states submit plans for approval that included any changes made since 2012. Many conservative states rejected these plans because they wanted to get out of providing Medicaid coverage. As a result, about 14 million people were prevented from becoming covered under Medicaid or the Children's Health Insurance Program (CHIP).
But many other states accepted the federal funds available under the ACA to expand their Medicaid programs, so now nearly all adults with income below 138% of the poverty line ($16,753 for an individual and $34,071 for a family of four in 2016) are covered. The share of Americans without health insurance has dropped from 13% in 2013 to 4.5% in 2016.
Children of low-income families could also become eligible for Medicaid or CHIP if their states chose to do so. About 7 million children already receive coverage through these programs, which allow families who meet certain requirements to be enrolled in state-sponsored health plans.
Recent analyses that incorporate outcomes beyond than those generally investigated in Medicaid expansion research demonstrate that expansion is related with lower total and particular condition mortality; lower rates of food insecurity, poverty, and house evictions; and higher levels of self-esteem. Evidence on access to care is mixed.
Expansion is also associated with improved preventive care utilization and management of chronic conditions. The evidence on mental health and substance abuse outcomes is limited but suggests improvements for people with mental illness.
Medicaid is the largest insurer in many states, covering more than 70 million Americans. It is therefore important for understanding how policies affect health outcomes.
Does Medicaid reduce hospitalizations? Evidence from both pre-and post-expansion studies indicates that it does. One study found that after controlling for patient characteristics, counties that adopted Medicaid had 4% fewer admissions for heart failure and 5% fewer admissions for respiratory diseases. Another study found that after accounting for differences in demographics and medical practice between counties that did and didn't adopt Medicaid, children living in counties that adopted Medicaid had 12% fewer hospitalizations for asthma.
Do Medicaid patients have better health outcomes? Yes.
The Affordable Care Act (ACA) extended Medicaid coverage to almost all people with incomes up to 138 percent of the federal poverty line ($17,609 for an individual in 2020). The law's architects expected that most states would expand their own Medicaid programs as well. However, only 18 states and the District of Columbia have done so as of 2014.
Under the law, any adult without access to affordable health insurance through their employer or a private insurer can apply for Medicaid coverage. Eligible adults must meet certain financial requirements to be approved for Medicaid. Those who are approved will receive coverage starting at age 65 or younger if applying before then, or when they become eligible regardless of age.
People usually think of Medicaid as providing coverage to poor individuals or families. However, under the ACA, all states were required to offer Medicaid coverage to anyone earning less than about $16,100 per year ($24,600 for a family of three). Above this level, many states chose to provide additional incentives such as reduced premiums or out-of-pocket costs for covering children or other groups not covered by Medicaid.
In addition to these mandatory participants, 26 states plus D.C. also established health care exchanges where residents could purchase insurance policies. These policies could include Medicaid as one of their options.