Macroeconomic Feedback Effects of Medicaid Expansion: Evidence from Michigan

Authored by read.dukeupress.edu and submitted by smurfyjenkins

Context: Medicaid expansion has costs and benefits for states. The net impact on a state's budget is a central concern for policy makers debating implementing this provision of the Affordable Care Act. How large is the state-level fiscal impact of expanding Medicaid, and how should it be estimated?

Methods: We use Michigan as a case study for evaluating the state-level fiscal impact of Medicaid expansion, with particular attention to the importance of macroeconomic feedback effects relative to the more straightforward fiscal effects typically estimated by state budget agencies. We combine projections from the state of Michigan's House Fiscal Agency with estimates from a proprietary macroeconomic model to project the state fiscal impact of Michigan's Medicaid expansion through 2021.

Findings: We find that Medicaid expansion in Michigan yields clear fiscal benefits for the state, in the form of savings on other non-Medicaid health programs and increases in revenue from provider taxes and broad-based sales and income taxes through at least 2021. These benefits exceed the state's costs in every year.

Conclusions: While these results are specific to Michigan's budget and economy, our methods could in principle be applied in any state where policy makers seek rigorous evidence on the fiscal impact of Medicaid expansion.

Bunnythumper8675309 on January 8th, 2020 at 17:03 UTC »

Michigan passed a work requirement before Snyder left. They want to boot as many people as they can off the program.

ValidatingUsername on January 8th, 2020 at 16:37 UTC »

Who would have thought preventative measures and healing before severe complications would reduce overall costs

Edit1 : u/Inside_my_scars

is the winner for first person to deliver actual facts on the topic

Edit2 : u/BGAL7090

Okay. Here's a map that shows the status of Medicare expansion policies being adopted on a state-by-state basis. It has pretty colors and gives you more detail if you mouse over a particular state.

Here is a less interactive but still just as colorful map showing the general status of all states and their politicians after the 2018 mid term election.

If you'd like analysis, here you go: The remaining holdouts that have refused to adopt Medicare expansion are as follows. Alabama, Florida, Georgia, Kansas, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming.

Of those states, the following had or maintained Republican control in both the House of Representatives and in the Senate: Alabama, Florida, Georgia, Mississippi, Missouri, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, and Wyoming.

Kansas, North Carolina, Wisconsin are the only 3 that did not maintain a Republican control of both, but are all split along party lines.

In summation, 78% of the states that have not adopted Medicare Expansion have Republican control of both the House and the Senate. The remaining 22% have split control over the state. This shows a clear tendency towards Republican-led states not adopting the Medicare Expansion policy.

I'll say it for those of you in the front: It's okay to not want to get too deep into politics because there are too many assholes that refuse to apply critical thinking and use basic reasoning skills.

forrest38 on January 8th, 2020 at 15:50 UTC »

This was completely expected.

The Congressional Budget Office determined that the Affordable Care Act (i.e. Obamacare) would reduce the deficit by $143 billion due to a decrease in emergency room visits, which states are required by law to pay for. Any state that turned down the Medicare expansion not only was saying we don't want our citizens to have access to healthcare, but also that we want to spend more on healthcare overall since ER visits are far more expensive than preventing care methods.

It has also been found:

The Affordable Care Act (Obamacare) reduced disparities in healthcare outcomes by socio-economic class

The CommonWealth group compiled a report in 2019 that ranked the overall healthcare outcomes (page 17/65) of all 50 states. 18/20 worst performing states voted for Trump, while 15/20 best performing states voted for HRC. The study found a direct correlation between states that accepted Obamacare and Superior Healthcare outcomes.

The areas of the country that most strongly voted for Trump had the highest increases in mortality over the past 35 years and the CDC found that in 2018, Life Expectancy for Uneducated White Males dropped for the third straight year.