Medicaid Expansion Found to Reduce Mortality Rates

Originally, the Affordable Care Act expanded Medicaid coverage to 138% of the Federal Poverty Level. With the Supreme Court’s decision on the Affordable Care Act leaving the decision about whether or not to expand Medicaid up to the states, there will be a good opportunity to compare and contrast the outcomes between the states that opt-in and opt-out. While that will be interesting to see, we already have some states who expanded Medicaid over the last decade to use in predicting the results.

States that have expanded Medicaid have seen a reduction of mortality rates among low income adults by 6.1 percent.

That from Benjamin D. Sommers, M.D., Ph.D., Katherine Baicker, Ph.D., and Arnold M. Epstein, M.D., in their study “Mortality and Access to Care among Adults after State Medicaid Expansions” published in theNew England Journal of Medicine (2012). The study examined adults between the ages of 20 and 64 in Maine, New York and Arizona — three states that expanded coverage since 2000, compared with similar adults in New Hampshire, Pennsylvania, Nevada and New Mexico, neighboring states that did not do so.

Beyond the mortality rate, the study also found a 25% increase in Medicaid coverage, 15% lower rates of uninsurance, a 21% reduction in cost-related delays in care, and a 3% increase in self-reported excellent or very good health.

These findings are similar to the 8.5% and 5.1% population-level reductions in infant and child mortality, as estimated in analyses of Medicaid expansions in the 1980s by Janet M. Currie and Jonathan Gruber published in the Journal of Political Economy and Quarterly Journal of Economics respectively.