Medicaid Expansion: A Matter of Life and Death

by | Jul 22, 2019 | Issues, Medicaid

Today in the News & Observer, an op-ed ran criticizing the Democrats’ apparent schemes to expand the size of government for no good reason. The piece begins:

The Democrats’ plan for Medicaid expansion in North Carolina is not just bad policy, it is also dangerous because it reflects the left’s use of dishonest rhetoric and misleading math to vastly increase the power of government.

A strong start. Never mind the fact that plenty of Republican states, ruby red, have expanded Medicaid not because they are big-government, tax and spend liberals, but because it’s actually good policy and good for their constituents.

The piece goes on, basically, to parrot the talking points attended by Senator Berger, the one man in the state with the power to keep Medicaid expansion from happening.

But lo, this line stands out:

As inefficient and ineffective as government is — there is little evidence so far that expansion has significantly improved health outcomes and plenty of cases of fraud and abuse as ineligible people sign up for benefits — this spending raises the unasked question of whether there is a better way to help relatively young, able-bodied people receive care?

“There is little evidence so far that expansion has significantly improved health outcomes…” but today, just as this article hit the pages of the N&O, a new study appeared looking at mortality rates among states that accepted expansion.

The conclusion of that study:

There is robust evidence that Medicaid increases the use of health care, including types of care that are well-established as efficacious such as prescription drugs and screening and early detection of cancers that are responsive to treatment. Given this, it may seem obvious that Medicaid would improve objective measures of health. However, due to data constraints, this relationship has been difficult to demonstrate empirically, leading to widespread skepticism that Medicaid has any salutary effect on health whatsoever. Our paper overcomes documented data challenges by taking advantage of large- scare federal survey data that has been linked to administrative records on mortality. Using these data, we show that the Medicaid expansions substantially reduced mortality rates among those who stood to benefit the most.

Furthermore, in states that chose not to expand Medicaid, the study estimates that some 15,000+ Americans died who may otherwise have lived in the years since the Affordable Care Act introduced Medicaid expansion.

Far from being some ruse for Democrats to expand the size of government (to what end I know not), Medicaid expansion is a demonstrable tool in preventative care and saving the lives of the most vulnerable amongst us.

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