July 27Three researchers at the Harvard School of Public Health set out to test a very basic premise.
"Several states have expanded Medicaid eligibility for adults in the past decade, and the Affordable Care Act allows states to expand Medicaid dramatically in 2014," the three write in a New England Journal of Medicine article released Wednesday. "Yet the effect of such changes on adults' health remains unclear. We examined whether Medicaid expansions were associated with changes in mortality and other health-related measures."
Their findings? Well, it was kind of a "duh" moment.
"State Medicaid expansions to cover low-income adults were significantly associated with reduced mortality as well as improved coverage, access to care, and self-reported health," Drs. Benjamin D. Sommers, Katherine Baicker and Arnold M. Epstein write.
In the study, states where Medicaid coverage has been expanded to more low-income people New York, Maine and Arizona saw a marked decline in deaths of residents ages 20 to 64 when compared to four nearby states that did not expand the program Pennsylvania, Nevada, New Mexico and New Hampshire.
Providing Medicaid coverage saves lives, the study found. Expect to see one life saved for every 176 uninsured Americans added to the program.
"Policymakers should be aware that major changes in Medicaid either expansions or reductions in coverage may have significant effects on the health of vulnerable populations," the New England Journal of Medicine article reported.
We agree, but we worry about that message being comprehended by policymakers. Let's face it. These findings are not all that new or groundbreaking. Yet, Republican opponents of President Barack Obama's health reforms have stubbornly resisted them despite the evidence of our very simple math.
We will be a better nation with universal health insurance, something, sadly, the law won't fully achieve. Americans who lack health insurance often find themselves in a bind. They often must choose between a trip to the doctor and having enough gas in the tank to get to work. They often must decide between eating a healthy meal or paying for costly prescription medicines. This tension produces awful results.
When the worst happens and the illness the uninsured have long ignored becomes acute, they wind up in a hospital emergency room, where the costs are triple or more and the system is already heavily stressed.
This is a strain on the patients, on the hospitals and on health-care providers. And, because these expenses are absorbed in the most inefficient way possible, this is a strain on the nation's economy.
The supporters of the Affordable Care Act, known as Obamacare to some, recognized this problem. By 2014, the health reforms that recently won the approval of the Supreme Court will begin expanding Medicaid to more low-income, uninsured Americans. That could mean 17 million Americans currently without coverage will have it over the decade. That, if we trust the work of these three Harvard researchers, will save lives.
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