Rejecting the Medicaid expansion could kill nearly 6,000 people a year

Rejecting the Medicaid expansion could kill nearly 6,000 people a year

Like many other liberal health-policy wonks, I’ve written a lot about the value of health reform in improving access to preventive care, protecting people against crippling medical debt and improving people’s physical and mental health.

I haven’t written much about how better access to health care can actually save lives. The argument for the Affordable Care Act, President Obama’s signature health-care-law, doesn’t ride on this. Moreover, the connection between health insurance and mortality is really hard to pin down, even if insurance truly has strong protective effects. The uninsured in America are mainly non-elderly adults. Deaths are really rare in this population, on the order of 0.4 percent per year. according to an Urban Institute study. Real-world randomized clinical trials—even those with thousands of patients—are just too small and too brief to reliably determine how much we might reduce mortality by extending coverage to the uninsured.

On Monday, though, a beautiful study was published in Annals of Internal Medicine that provides some of the best data we have connecting health coverage to saved lives. It’s changed my thinking, too. I’m more confident than I was last week that the ACA will save many thousands of lives every year.

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