Study: People In Medicaid Expansion States Healthier Than Those Without It

A new study suggests that low-income people living in states with Obamacare’s Medicaid expansion are healthier than those in states without it, the New York Times reported. The study’s authors — who published their results in JAMA Internal Medicine Monday — were hesitant to say that Medicaid expansion prompted the results, the Times said, but the low-income people surveyed in expansion states Kentucky and Arkansas reported feeling healthier than those in Texas, a non-expansion state. The study comes as another report released Monday by the Urban Institute estimated that for every $1 state spends on its Medicaid expansion program, it brings in $7 to $8 in federal spending.

Currently, 19 states have refused to expand Medicaid.

The health survey found that respondents in Kentucky and Arkansas were, by nearly 5 percentage points, more likely to report being in excellent health than those in Texas. They were also less likely to skip taking medication due to costs, less likely to visit the emergency room and more likely to have access to primary care.

There were no difference in sex, income, or marital status among the low-income people surveyed in Texas, Kentucky and Arkansas. The Texas respondents were younger, more urban, and disproportionately Latino. Kentucky and Arkansas have different models of expanding Medicaid — the former going with a more conventional approach, while the latter uses Medicaid funds to offer private insurance to low-income individuals — but for the most part the two states exhibited similar results when the health outcomes of the respondents was surveyed.

The researchers surveyed the states’ residents three times: first in 2013, before Medicaid expansion was enacted; then in 2014, a year after its implementation, and again at the end of 2015.

The Urban Institute, with the funding of the Robert Wood Johnson Foundation, released a report Monday projecting federal and state spending if the 19 non-expansion states opted into Medicaid expansion.

While the 19 non-expansion states would spend a total of $75.9 billion if they expanded Medicaid with moderate enrollment because of the increase in caseloads, that money would be matched by $568.5 billion in federal funds. The states, meanwhile, would save $21.8 billion in uncompensated costs, while the U.S. government would save $129.1 billion in reductions in federal subsidies on exchanges, along with its own $34.9 billion saved in uncompensated care.

The projected savings for states in uncompensated care grow to $27.1 billion for the non-expansion states, if their Medicaid expansion featured high enrollment rates instead of moderate enrollment.