Better health, fewer deaths linked to Medicaid expansion


The theory guiding the Affordable Care Act’s call for expanding Medicaid to more low income and working-poor Americans is pretty simple: Getting them access to basic medical care will improve their lives and, in the long, run help control the overall cost of health care for millions of previously uninsured people.Mike King headshot 2

But measuring whether that theory works — beyond the anecdotal stories we’ve all heard — is exceedingly difficult, especially since the law is only a couple of years since being implemented.

The statistical evidence is beginning to come in, as illustrated here by this New York Times report about a study in the latest edition of JAMA Internal Medicine.

Looking at health surveys of people in neighboring states — one that expanded Medicaid and one that didn’t — researchers found that, in general, people who qualified for Medicaid in places where enrollment expanded reported better health than their demographically similar counterparts in states that have refused to expand the program. Moreover, those who got coverage reported two consecutive years of better health in follow up surveys.

Deeper dives into health care outcomes in years to come will be needed but this latest study is an indication that expanding Medicaid as the ACA envisioned it appears to be working. These same researchers using similar data points and surveys, two years ago calculated the predicted annual number of lives lost in states that refused to expand Medicaid.

In Georgia, that number is 1,170.

Let that sink in.

More than a thousand Georgians die every year because they don’t have insurance and can’t afford health care. If they lived in Ohio, or New Jersey or another state where Medicaid is available, they would be alive. Why is this not a public health priority?

By way of comparison, the Governor’s Office of Highway Safety wants Georgia to continue the note worthy trend of reducing the state’s annual death toll from traffic fatalities. The target for 2016 is 1,130. That’s a big challenge, given how crowded Georgia’s interstates and highways are.

It would be nice if we could get the number of Georgians who die because of lack of access to Medicaid down as well. That’s not so big a challenge. It’s pretty simple, actually.

Expand Medicaid. Save lives. Improve health.

Mike King is the Author of A Spirit of Charity: Restoring the Bond between America and Its Public Hospitals,” available through and the Seattle Book Co.

Read The New York Times review of the book:


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