Short Takes On News & Events

Medicaid Expansion Reduces Mortality, Study Finds

By Matthew Fleming

July 25th, 2012, 5:00 PM

As states decide whether to expand their Medicaid programs to cover low-income childless adults, the impact of their choices became clearer today in a study showing a reduction of mortality in states that have already made that move.

The research published in the New England Journal of Medicine found a 6.1 percent reduction in mortality among low-income 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.

The decline in mortality, by an overall 19.6 deaths per 100,000 adults, was especially pronounced among older individuals, minorities and residents of the poorest counties.  The researchers analyzed data spanning  five-year periods before and after the three states extended their Medicaid coverage to poor, childless adults.

The study also found “improved coverage, access to care and self-reported health” among the newly covered adults.

“It seems intuitive, but there’s been surprisingly little evidence so far,” said lead researcher Benjamin D. Sommers, M.D., Ph.D., an assistant professor of health policy and economics at the Harvard School of Public Health.  “There’s been some [research] on pregnant women and children, but much less on adults.  And right now there are a significant number of people arguing that Medicaid is worse than nothing at all.”

The Supreme Court on June 28 struck down as unduly coercive a provision of the 2010 federal  health care law that sought to force all states to extend Medicaid coverage to everyone with incomes up to 133 percent of the federal poverty level — currently  $14,856 for individuals and $25,390 for a family of three. Although the federal government will pay the full cost of the expanded coverage for three years starting in 2014, and at least 90 percent thereafter, a number of state governors have said they will not approve the wider coverage.

The study’s authors — Sommers, Katherine Baicker, Ph.D. and Arnold M. Epstein, M.D. — said their research results are consistent with previous analyses finding an 8.5 percent reduction in infant mortality and a 5.1 percent drop in child mortality  as a result of Medicaid expansions in the 1980s.

The authors cautioned that their study “cannot definitively show causality,” because other factors might have contributed to the reduction in death rates in the population newly covered by Medicaid. Among those factors, they said, was the possibility that “expanding coverage had positive spillover effects through increased funding to providers, particularly safety-net hospitals and clinics.” But they said they were not aware of any large-scale changes in health policy in the three states they studied.

“This answers the question of what happens when you give people Medicaid who didn’t already have coverage, as opposed to comparing people who have Medicaid with people who have something else,” said Sommers.  “The latter is not apples to apples, because Medicaid recipients are usually sicker and with worse socioeconomic conditions.”

8 Responses to “Medicaid Expansion Reduces Mortality, Study Finds”

  1. larry cane says:

    “As states decide whether to expand their Medicaid programs to cover low-income childless adults, the impact of their choices became clearer today in a study showing a reduction of mortality in states that have already made that move.”

    At least 15 governors have indicated they will not participate in the expansion of Medicaid under the healthcare law. It’s has nothing to do with mortality. These governors have absolutely no interest in where they rank with regard to mortality. All that these Neanderthal governors care about is making sure President Obama is a one term President. If it means that people will die, these governors could not care less.

  2. SteveH says:

    “It’s has nothing to do with mortality.”

    It’s got nothing to do with morality either. The expansion will save lives, the governors who oppose it don’t care.

  3. Gerard Mayer says:

    Congrats Larry, You have broken the code!
    To add insult to injury, these “leaders” care less about the health care institutions in thier states who will have to bear the unnecessary burden of uncompinsated care which we the state taxpayers must absorb! When this hits the hospitals you can say bye bye to those who made the disasterous descision.

  4. larry cane says:

    If you have ever lived in the south or the southwest, then you would know how things work down there. I have lived there and, believe me, I know how things work. Gerrymandering and stuffing ballot boxes is a GOP art form. Voter fraud that favors Republican candidates is rampant. How else do these GOP Neanderthals keep getting re-elected?

  5. larry cane says:

    The irony of this whole thing is, many of these governors call themselves Christians! Imagine that! Christians? Who are they kidding? The very nature of Medicaid is to help those less fortunate than ourselves. The very nature of Medicaid is to help the needy now and ask questions later. Medicaid is Christianity in a nutshell. These so-called “Born-Again Christian” governors have absolutely no idea that Medicaid and Christianity go hand in hand. There’s a world filled with hungry and less fortunate people. It’s always been that way. The Bible teaches, “The poor will always be with us…”. If those who merely “say” they follow the example of Jesus Christ actually tried to live up to the standard set by Jesus Christ, actually behaved as though they were being observed by the very God that they say they love and worship so much, then Medicaid would be funded and expanded well beyond what these skinflint cheapskate governors had ever dreamed. These so-called evangelical hypocrites need a reality check. By refusing to expand Medicaid, they are exposing the truth about themselves. They’ll sit in church pews on Sunday and act all whitewashed and faultless. Then, on Monday morning, they’ll be back at the office taking steps to defund the Medicaid program. There’s a fundamental problem when you tell your pastor that you’ll try hard to follow the Christian example and then refuse to help the poor and needy in society. That’s the definition of hypocrisy.

  6. Brady says:

    Please list the “15 Governors” who have allegedly already stated unequivocally they will not participate in the Medicaid expansion. I think you’re going to have a hard time doing that.

  7. Paula says:

    “Please list the “15 Governors” who have allegedly already stated unequivocally they will not participate in the Medicaid expansion. I think you’re going to have a hard time doing that.”

    Gee, that wasn’t hard at all!

    All I did was cut and paste these words into my search engine…

    “Fifteen governors reject or leaning against expanded Medicaid program”

  8. Paula says:

    By the way, where in this thread does anyone but Brady say the word “unequivocally”? I’ve searched and I’ve searched and the only place I see the word “unequivocally” is in Brady’s post. Can someone help me here?

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