Repealing Medicaid Expansion Could Lead to Thousands of Deaths in the U.S. Annually

According to a recent report from Vox, Congressional plans to repeal key provisions of the Affordable Care Act (ACA) will have devastating consequences for thousands of Americans each year. Vox’s Julia Belluz cites evidence to estimate that 24,000 Americans would die annually if Congress repeals vital provisions of the ACA without simultaneously enacting an appropriate replacement package.[1]

The reporter’s figure comes from a May 2014 Annals of Internal Medicine study comparing the mortality rates in Massachusetts counties from the 2001-2005 time period (prior to the state’s health reforms that included efforts to strengthen the individual insurance marketplace) to the 2007-2010 period (after these same reforms had had time to take effect). The Annals of Internal Medicine article estimates that, following their enactment, Massachusetts’ health reforms saved 320 lives per year.[2]

At the end of last year, the Obama Administration’s White House Council of Economic Advisers extrapolated the findings from the Annals study to the national level and concluded that 24,000 Americans would die per year if these health reforms that both the Massachusetts and ACA systems share in common were repealed.[3] Both the Massachusetts plan and the Affordable Care Act, for instance, offer subsidies to help people buy insurance on the individual marketplaces, require individuals to pay a penalty if they lack insurance, and penalize businesses for not offering affordable insurance.[4]

The reporter also highlights a 2012 New England Journal of Medicine article’s comparing counties in the 31 states and the District of Columbia that expanded Medicaid to counties with similar demographics in states that did not expand Medicaid.[5] Belluz writes that “mortality declined in places that expanded Medicaid by 20 deaths per 100,000, unlike neighboring states that didn’t expand Medicaid.”[6] She then links to a Washington Post article that extrapolates this figure nationally. The Post piece concludes that rescinding the ACA-authorized Medicaid expansion in these 31 states and DC would lead to the deaths of over 43,000 Americans per year.[7]

The Center for Medicare Advocacy continues to fight to ensure that the Affordable Care Act, Medicaid, and Medicare at least maintain their essential, defined benefits for those currently covered. We will continue to work to keep these vital programs strong and affordable for present and future generations.

February 22, 2017 – M. Hubbard