Harvard study: Increased Medicaid coverage reduces mortality rates

BOSTON — A new study from Harvard School of Public Health found that expanding Medicaid to low-income adults led to improved health and reduced mortality. It is the first published study to look specifically at the effect of recent state Medicaid expansions on mortality among low-income adults.

“The recent Supreme Court decision on the [Patient Protection and the Affordable Care Act] ruled that states could decide whether or not they wanted to participate in the health care law’s Medicaid expansion. Our study provides evidence suggesting that expanding Medicaid has a major positive effect on people’s health,” stated Benjamin Sommers, assistant professor of health policy and economics at HSPH and the study’s lead author.

The study was published online July 25 and will appear in the Sept. 13 print issue of the New England Journal of Medicine.

The HSPH researchers analyzed data from three states — Arizona, Maine and New York — that had expanded their Medicaid programs to childless adults (ages 20 to 64 years) between 2000 and 2005. They selected four neighboring states without major Medicaid expansions — New Hampshire (for Maine), Pennsylvania (for New York) and Nevada and New Mexico (for Arizona) — as controls. The researchers analyzed data from five years before and after each state’s expansion.

The results showed that Medicaid expansions in three states were associated with a significant reduction in mortality of 6.1%, compared with neighboring states that did not expand Medicaid, which corresponds to 2,840 deaths prevented per year for each 500,000 adults gaining Medicaid coverage. Expansions also were associated with increased Medicaid coverage, decreased uninsurance, decreased rates of deferring care due to costs, and increased rates of “excellent” or “very good” self-reported health.


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