Expanding Medicaid to low-income adults leads to widespread gains in coverage, access to care and improved health and reduced mortality, according to a study.
Researchers from the Harvard School of Public Health said their study is the first to look specifically at the effect of recent state Medicaid expansions on mortality among low-income adults, and the findings suggest that expanding coverage to the uninsured may save lives.
"The recent Supreme Court decision on the Affordable Care Act ruled that states could decide whether or not they wanted to participate in the healthcare law’s Medicaid expansion," Benjamin Sommers, MD, PhD, assistant professor of health policy and economics at HSPH and the study’s lead author, said in a news release. "Our study provides evidence suggesting that expanding Medicaid has a major positive effect on people’s health."
In the past decade, several states expanded Medicaid from its traditional coverage of low-income children, parents, pregnant women and disabled people to include poor adults without any children living at home.
Medicaid covers 60 million people, and the ACA would extend eligibility to up to 17 million more. However, the Supreme Court decision gives states the option of choosing whether or not to expand coverage.
HSPH researchers analyzed data from Arizona, Maine and New York, three states that had expanded their Medicaid programs to childless adults (ages 20-64) between 2000 and 2005. They selected four neighboring states without major Medicaid expansions: New Hampshire (for Maine), Pennsylvania (New York) and Nevada and New Mexico (Arizona).
Analyzing data from five years before and after each state’s expansion, the researchers found that Medicaid expansions in three states were associated with a reduction in mortality of 6.1% compared with neighboring states that did not expand Medicaid. That reduction corresponds to 2,840 deaths prevented per year for each 500,000 adults gaining Medicaid coverage.
Mortality reductions were greatest among older adults, nonwhites, and residents of poorer counties. Expansions also were associated with increased Medicaid coverage, decreased absence of insurance, decreased rates of deferring care due to costs and increased rates of "excellent" or "very good" self-reported health.
The groups that benefitted from Medicaid expansion in this study — older adults, racial and ethnic minorities and those living in poor areas — are groups that traditionally have had higher mortality rates and faced greater barriers to care. The study results provide valuable evidence for state policymakers deciding whether or not to expand Medicaid, the authors wrote.
The study appeared July 25 on the website of the New England Journal of Medicine. To read it, visit http://bit.ly/MIw1HA.
Researchers from the Harvard School of Public Health said their study is the first to look specifically at the effect of recent state Medicaid expansions on mortality among low-income adults, and the findings suggest that expanding coverage to the uninsured may save lives.
"The recent Supreme Court decision on the Affordable Care Act ruled that states could decide whether or not they wanted to participate in the healthcare law’s Medicaid expansion," Benjamin Sommers, MD, PhD, assistant professor of health policy and economics at HSPH and the study’s lead author, said in a news release. "Our study provides evidence suggesting that expanding Medicaid has a major positive effect on people’s health."
In the past decade, several states expanded Medicaid from its traditional coverage of low-income children, parents, pregnant women and disabled people to include poor adults without any children living at home.
Medicaid covers 60 million people, and the ACA would extend eligibility to up to 17 million more. However, the Supreme Court decision gives states the option of choosing whether or not to expand coverage.
HSPH researchers analyzed data from Arizona, Maine and New York, three states that had expanded their Medicaid programs to childless adults (ages 20-64) between 2000 and 2005. They selected four neighboring states without major Medicaid expansions: New Hampshire (for Maine), Pennsylvania (New York) and Nevada and New Mexico (Arizona).
Analyzing data from five years before and after each state’s expansion, the researchers found that Medicaid expansions in three states were associated with a reduction in mortality of 6.1% compared with neighboring states that did not expand Medicaid. That reduction corresponds to 2,840 deaths prevented per year for each 500,000 adults gaining Medicaid coverage.
Mortality reductions were greatest among older adults, nonwhites, and residents of poorer counties. Expansions also were associated with increased Medicaid coverage, decreased absence of insurance, decreased rates of deferring care due to costs and increased rates of "excellent" or "very good" self-reported health.
The groups that benefitted from Medicaid expansion in this study — older adults, racial and ethnic minorities and those living in poor areas — are groups that traditionally have had higher mortality rates and faced greater barriers to care. The study results provide valuable evidence for state policymakers deciding whether or not to expand Medicaid, the authors wrote.
The study appeared July 25 on the website of the New England Journal of Medicine. To read it, visit http://bit.ly/MIw1HA.
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