Recent Study Highlights the Importance of Expanding Medicaid Coverage
By Patrick Reimherr and Elizabeth Lower-Basch
The Affordable Care Act calls for states to expand their Medicaid programs by 2014 to cover all individuals under the age of 65 with incomes below 133 percent of the federal poverty line. The recent Supreme Court decision means that states must choose whether to take up this provision and expand coverage to millions of people who currently lack stable access to quality care or leave millions of low-income adults without access to coverage.
A recent study published in the New England Journal of Medicine underscores the importance of the Medicaid expansion to low-income adults. The study, produced by three faculty members at the Harvard School of Public Health, compared data in, “three states that substantially expanded adult-Medicaid eligibility since 2000 (New York, Maine, and Arizona) with neighboring states without expansions” and found the expansions reduced rates of un-insurance, improved self-reported health outcomes, and decreased rates of delayed care because of costs. Most important, the expansion saved lives – significantly reducing the mortality rate among older, non-white adults residing in poorer counties.
These findings align with previous research on the subject. Families USA, a leading non-partisan health care affordability group, recently updated a 2002 Institute of Medicine (IOM) report that estimated the number of people nationwide who died in 2000 because they lacked health insurance. According to the IOM report, in 2000, almost 18,000 individuals ages 25 to 64 died because they did not have health insurance. This number, according to the Families USA study (June 2012), rose to 26,100 in 2010. In all, 2,175 people died prematurely every month, 502 people every week, 72 people every day, or three every hour because they did not have adequate health coverage. This closer look at the numbers demonstrates that health insurance is a necessity in the United States. Without it, people have less stable access to care, go without cost-saving preventative care, and delay or forgo life-saving treatments.
In 2009, more than 69 million individuals were enrolled in Medicaid. Of these, almost half were children. According to the Kaiser Family Foundation, if the expansion is fully implemented in all states, almost 16 million additional people would be covered through Medicaid. If a state chooses not to implement the Medicaid expansion, low-income adults falling above the federal poverty line will receive a subsidy to purchase insurance, while poorer Americans will be left without coverage. The federal government will fund 100 percent of the Medicaid expansion for three years and gradually decrease its support to 90 percent by 2020. Considering the fact that the federal government currently covers, on average, only 57 percent of Medicaid costs, this, as recently laid out in detail by the Center on Budget and Policy Priorities, is an exceptionally good deal for state governments. Nonetheless, in the wake of the Supreme Court ruling that Congress could not require states to implement the expansion, several State governors indicated that they would not participate, putting their partisan opposition to the law ahead of the pressing needs of their states’ low-income families.
Governors should recognize this opportunity to improve the lives of those who live in their states and begin making the changes necessary to ensure the law’s successful implementation.
To see the New England Journal of Medicine Study, view, Mortality and Access to Care among Adults after State Medicaid Expansions>>
To see the full Families USA study, view, Dying for Coverage: The Deadly Consequences of Being Uninsured>>
For more information on the specifics of the Supreme Court’s decision in National Federation of Independent Business v. Sebelius (NFIB), view, the National Health Law Program's, The Supreme Court’s Decision on the ACA’s Medicaid Expansion – NheLP Q&A#1>>