Health Insurance Navigator

By Lisa Zamosky

Last month, The Supreme Court’s ruling on the Affordable Care Act gave states the freedom to choose whether or not to expand their Medicaid programs, a central feature of the law intended to make health insurance available to millions of Americans.

Easing eligibility for Medicaid — the government program that provides health coverage to 60 million people of low income — was expected to cover an additional 17 million people over the next decade as a result of health reform.

The court’s ruling, which eliminated a stiff penalty for states refusing to expand their Medicaid program, has led a number of states to consider foregoing the expansion entirely. In fact, some have even begun to cut benefits to people already covered by Medicaid.

Expanding Coverage Extends Life

A new study from Harvard School of Public Health, published online in the New England Journal of Medicine, highlights the real-world implications of access to Medicaid coverage and the possible impact of states refusing to allow more people into the program.

Not only does expanding Medicaid increase access to health care, which in turn, enables better health for people of low income, coverage actually reduces the risk of death, researchers found.

The study compared three states — Arizona, Maine, and New York — that between 2000 and 2005 expanded their Medicaid programs to adults ages 20-64. They then compared those with four neighboring states that did not expand their Medicaid programs — New Hampshire, Pennsylvania, Nevada, and New Mexico. The study then looked at the five-year periods before and after Arizona, Maine and New York broadened access to their Medicaid programs.

Here’s what researchers found:

• Death rates were 6% lower in the states that expanded Medicaid as compared with those that didn’t (that equals 2,840 people kept alive for every 500,000 that gained coverage)
• Older adults, non-whites, and people living in poorer communities showed the biggest drop in number of deaths
• Fewer people put off health care because of the cost
• More people rated their own health as “excellent” or “very good”

The Politics of Health

Whether and which states will expand their Medicaid program is a hot policy and political debate. But as this and other studies I’ve discussed recently on this blog highlight (here and here), the connection between health insurance and good health — life, in fact — is real. It seems all too easy, in the midst of political debates, to forget the real people impacted by government policies.

I’d like to hear your thoughts on the matter: If, in fact, access to health insurance keeps people alive, do we have a responsibility to get health insurance ourselves and to make it available to those in our society who can’t afford it on their own?

Sound off in the comments section below.