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Thursday, May 8, 2014

Trending: Good Health Care News for Some, but Not All, Americans This Week

Ron Pollack

Executive Director

Two reports released this week confirm that the goals of the Affordable Care Act—comprehensive, affordable health coverage for all Americans—are making a dent in the numbers of uninsured and of those who die prematurely from lack of quality health care. This good news provides a stark contrast to those who live in states that haven’t expanded Medicaid—where uninsured low-income populations continue to suffer from the effects of not having access to health care.

Massachusetts’ universal health coverage reduces mortality rates

On Monday, the Annals of Internal Medicine published a study that examined how Massachusetts’ adoption of mandatory universal health coverage—the prototype of the Affordable Care Act—influenced mortality rates at a county level. The findings show that the mortality rate fell by about three percent in the four years after the state adopted its milestone health reform law.

Notably, the study found the steepest declines in mortality in areas of the state with the highest proportions of poor and previously uninsured individuals.

This confirms what prior studies and our own research have shown: Individuals who are uninsured defer treatment until it’s too late to treat their medical condition effectively and, as a result, tend to die prematurely. The Affordable Care Act’s wider health coverage goals mitigate this problem by making health insurance available to this vulnerable population.

The number of adults without health insurance continues to fall

And the numbers of uninsured individuals in this country are indeed falling. According to some estimates (see Monday’s new Gallup numbers), the percentage of uninsured adults has dropped to an all-time low of 13.4 percent (since 2008). While the Gallup numbers are, admittedly, derived from a poll with the usual limitations (self-reported participant responses, error rate, sampling size, and confidence intervals), when paired with the Massachusetts findings, it is nonetheless an encouraging indicator of both the potential and the current impact of the Affordable Care Act on the health and well-being of Americans.

States without Medicaid expansion continue to stymie the goals of the Affordable Care Act

But unfortunately, for the uninsured low-income residents who live in states that have not yet expanded Medicaid, the gains of the Affordable Care Act are a moot point. Many states with high uninsurance rates—among them Florida, Texas, and Georgia—are balking at expanding Medicaid. Elected officials in these states are essentially accepting poor health outcomes and premature mortality rates as a reasonable price to pay for eschewing federal dollars that would expand health coverage to vulnerable populations.

Expanding Medicaid to provide health care access for low-income residents in all states underscores a key takeaway from this week’s reports—if all states expanded Medicaid, what is good news for many Americans this week can become good news for all Americans, regardless of where they live.