Saving lives

Back in 2013, thousands of West Virginians came together to urge then Gov. Earl Ray Tomblin to expand Medicaid coverage to low income working adults under the Affordable Care Act.

He did.

(In retrospect, there was a good chance he would have done it anyway without all the shouting, but nobody wanted to leave that to chance.)

At the time, many advocates argued that doing so would save lives. Or, conversely, that failing to do so would cause unnecessary deaths.

The original federal legislation mandated expansion nationwide, but a 2012 U.S. Supreme Court decision made this a state option. That court decision, in effect, would prove to be a death sentence for thousands of Americans.

After five years of Medicaid expansion, researchers did the math, comparing mortality rates for low income “near elderly” Americans aged 55 to 64 in states that did and did not expand Medicaid. That demographic is more likely to benefit from coverage — and to suffer without it — than younger and presumably healthier Americans and elderly people eligible for Medicare.

The results, published by the National Bureau for Economic Research (NBER), found a .13 percentage point reduction in mortality for states that expanded Medicaid compared with those that did not.

According to the researchers, “The effect is driven by a reduction in disease-related deaths and grows over time.”

Specifically, 15,600 people died between 2014 and 2017 because their state didn’t expand Medicaid. That’s about five times the death toll from the 9/11 terrorist attacks.

If some other country would have caused that many American deaths, we would have gone to war.

In West Virginia, the news was better. Over the same period, the number of uninsured West Virginians fell by 56 percent. According to the NBER research, the expansion saved 87 lives per year in the Mountain State. That would be 435 lives over the five years the expansion has been in place.

And that’s just for the “near elderly.” The overall numbers would be higher.

It’s important to remember the life-saving facts about Medicaid expansion, which now covers over 155,000 West Virginians.

The program is under attack both by a federal lawsuit, supported by the state’s attorney general, and by potential state legislation that would impose work reporting requirements which could kick 38,000 to 71,000 out of coverage.

The research shows that this is literally a matter of life and death.

(This ran as an op-ed in the Charleston Gazette-Mail.)

Stating the obvious

It's been five and a half years since then Governor Tomblin (where are you when we need you?) decided to expand Medicaid coverage for low income working West Virginians under the Affordable Care Act. A recent study by the Georgetown University Center for Children and Families found what you might expect: it was a good idea, one that literally changed and saved lives.

As I mentioned in the last post, the recent election not only strengthens the position of those states that have expanded the program--it opens the way for Medicaid expansion in several holdout states. According to the Center on Budget and Policy Priorities,

"If all remaining non-expansion states (including Idaho, Nebraska, and Utah) adopted the expansion in 2019, more than 4.5 million uninsured people would gain coverage and uninsurance rates in these states would fall by a quarter, according to Urban Institute projections."

Let's hope we get there.