Most people are familiar with the way that the Affordable Care Act (ACA) has allowed more Americans to become insured than ever before. Advocates of the legislation tend to focus on the number of people who enroll as a way to justify their support, but it’s worth taking an even closer look to see what exactly this access to health insurance means for Americans — the numbers are heartening.
The latest report shows that fewer infants have died following the passage of the Affordable Care Act.
Published in the American Journal of Public Health, the newly released study found that between 2010 and 2016 fewer babies died in states that accepted the expansion of Medicaid under the Affordable Care Act than in states that did not expand their program.
Moreover, during the implementation of the Affordable Care Act from 2014 to 2016, average infant mortality rates rose in states that had not expanded Medicaid coverage.
The analysis of infant mortality rates indicated that the national trend had been in decline since 2010. The Affordable Care Act, nonetheless, accelerated that trend in states that opted to expand Medicaid; in fact, by 2016, those states enjoyed a 50 percent higher reduction in infant deaths.
Reducing Racial Disparity through Expanded Access to Health Insurance
While the Affordable Care Act benefited Americans living in states that expanded their Medicaid programs, African-Americans experienced the most pronounced decline in infant mortality rate over the course of the study, a reduction more than double than in states without Medicaid expansion. Before the Affordable Care Act, the infant mortality rate among African-Americans was over twice as high as for white and Hispanic infants. It follows that states with Medicaid expansion experienced substantial reductions in racial disparity among those rates.
A 2017 study also found that the Affordable Care Act was of particular benefit to underserved groups. African-Americans and Hispanics experienced a 20 percent reduction in brain injury-related deaths compared to data before the passage of the Act.
Why Infant Mortality Rates Fell Faster in States with Expanded Medicaid
The rate of women who were uninsured dropped considerably due to the implementation of the Affordable Care Act, allowing more access to hospital-related maternity services and postpartum care, as well as treatment of chronic illnesses, contraception, and substance abuse screening. The authors of the study also cited evidence that the number of unwanted pregnancies declined under the expansion of Medicaid. The authors reported there is a higher risk of infant deaths resulting from unintended pregnancies.
Saving Lives, Increasing Quality of Life
A study published last year found that the Affordable Care Act helped more people to quit smoking. States with expanded Medicaid experienced an increase in the incidence of quitting smoking, whereas states that declined expansion saw no change. Ultimately, this access to programming geared toward quitting smoking will improve and extend patients’ lives, though we won’t see those statistics for a while.
Another study found that Medicaid expansion reduced the use of predatory payday loans by 11 percent, constituting a reduction of payday loan debt and the number of individual borrowers. These findings suggest far-reaching economic benefits for individuals covered by the Affordable Care Act, and experts closely link finances to health; people with personal debt suffer a rate of mental illness three times higher than that of people without indebtedness. Individuals with debt are also four times more likely to experience depression, anxiety, and panic disorders.
In the short term, it’s clear that the Affordable Care Act saves lives. It also has the effect of improving quality of life, which ultimately will save even more lives in the long run.
BDB_JCD on January 30th, 2018 at 13:18 UTC »
Makes sense when you realize half of all births in the US are paid for by Medicaid.
https://khn.org/news/nearly-half-of-u-s-births-are-covered-by-medicaid-study-finds/
SirT6 on January 30th, 2018 at 13:10 UTC »
This title is a bit of a mess (and the piece it links to as well).
All states have seen a decline in infant mortality since the implementation of the Affordable Care Act (mortality rate 6.9 per 1,000 live births in 2010 vs. 5.9 per 1,000 in 2016).
In 2014, a feature of the ACA would have expanded access for Medicaid to people living at up to 133% of the poverty line. The US Supreme Court ruled that this aspect of the law was unconstitutional, and that states had the right to opt in. Most did, but a large number of (mostly Republican led) states did not.
This article is comparing trends in mortality for states that opted in to Medicaid expansion vs. those that did not over the two year period, from 2014 to 2016.
States that opted in: 5.8 per 1,000 -> 5.6 per 1,000 States that did not opt in: 6.4 per 1,000 -> 6.5 per 1,000
Is this solely a result of Medicaid expansion? Probably not. Lots of other things are going on as well. Demographically, states that did not opt in are, on average, poorer and present with more co-morbidities. Would Medicaid expansion have helped people in these states? Probably. Would it have been worth the money? That's the subject of large policy debates.
On the subject of infant mortality in the US vs. other countries, something that many people don't appreciate is that it is hard to make apples to apples comparisons since the methodology for collecting this data can vary pretty considerably. For example, most European health agencies will categorize deaths of *premature births as stillborn whereas the US will categorize the same as an infant death.
This CDC report breaks down the methodology differences pretty nicely.
rxneutrino on January 30th, 2018 at 12:23 UTC »
The US as a whole has pretty embarrassing infant mortality rates. We're 27th in the world. Despite medical care costing more, a baby born in the US is more than twice as likely to die before it's first birthday than one born in a country like Spain, Korea, or Finland.
And theres a big difference between states. Mississippi for example has infant mortality rates ranking between Bahrain and Botswana according to CDC. Source