Medicaid and Mortality: New Evidence from Linked Survey and Administrative Data

Authored by academic.oup.com and submitted by mvea

We use large-scale federal survey data linked to administrative death records to investigate the relationship between Medicaid enrollment and mortality. Our analysis compares changes in mortality for near-elderly adults in states with and without Affordable Care Act Medicaid expansions. We identify adults most likely to benefit using survey information on socioeconomic status, citizenship status, and public program participation. We find that, prior to the ACA expansions, mortality rates across expansion and nonexpansion states trended similarly, but beginning in the first year of the policy, there were significant reductions in mortality in states that opted to expand relative to nonexpanders. Individuals in expansion states experienced a 0.132 percentage point decline in annual mortality, a 9.4 percent reduction over the sample mean, as a result of the Medicaid expansions. The effect is driven by a reduction in disease-related deaths and grows over time. A variety of alternative specifications, methods of inference, placebo tests, and sample definitions confirm our main result.

IKilledMyCloneAMA on February 4th, 2021 at 17:00 UTC »

Can someone explain to me the maths behind this? The abstract of the study itself says that there was an annual 0.1% decline in mortality rates per year, which is a lot less impressive-sounding than 9.4%. Where did they pull the latter figure from?

Nomandate on February 4th, 2021 at 14:16 UTC »

Also: the expansion of health systems into rural areas that couldn’t previously support them.

We went from a dinky hospital that was notoriously a place to go and die to a huge multi-campus system with top notch docs.

https://www.ruralhealthinfo.org/topics/healthcare-access/resources

https://www.kff.org/medicaid/issue-brief/the-role-of-medicaid-in-rural-america/

Mr-Jings on February 4th, 2021 at 14:09 UTC »

That’s great! Just imagine how many lives could be saved if we expanded to Universal Healthcare. Millions of lives saved. Billions of dollars of healthcare debt wiped out.