On Friday, October 19, GBPI will host its Fall Policy Forum, Expanding Health Coverage in Georgia, to discuss the benefits of the Medicaid expansion under the Affordable Care Act. Attendees will hear from two nationally renowned health care policy experts who recently authored groundbreaking studies that highlight the substantial benefits of Medicaid coverage: Dr. Heidi Allen and Dr. Benjamin Sommers.
Dr. Benjamin Sommers, Assistant Professor of Health Policy and Economics at the Harvard School of Public Health, is our guest blogger this week.
Expanding Health Coverage in Georgia
In advance of my visit to the Georgia Budget and Policy Institute next month, I am happy to have the chance to write a bit about what I’ll discuss.
The topic of the day is ‘Expanding Health Coverage in Georgia.’ More specifically, I will talk about our research findings on the question: “What happens when states expand Medicaid to low-income adults?”
This is a critical policy question right now, as the Supreme Court ruling on the Affordable Care Act (ACA) essentially gave states the option of whether to participate in the law’s large expansion of Medicaid eligibility. Traditionally, Medicaid has only served people in specific ‘categories of eligibility,’ such as pregnant women, those with disabilities, and low-income parents and children. Millions of poor Americans without health insurance have been left out. In most states, including Georgia, it does not matter how poor a person is – if they do not have kids at home and do not have a disability, they are not eligible for Medicaid.
So, as states weigh their options for 2014 under the ACA, the natural question is, “What happens to people when they get Medicaid coverage?” Working with two colleagues at the Harvard School of Public Health (Arnie Epstein and Kate Baicker), we set out to answer this question. We studied three states that had chosen to expand Medicaid eligibility to all low-income adults about 10 years ago: New York, Arizona, and Maine. We compared those states to neighboring states with similar populations that had not expanded Medicaid.
The results were striking: expanded Medicaid eligibility cut the number of uninsured adults by about 15%, increased access to care and self-reported health status, and – most importantly – reduced the statewide death rate among adults by 6%. Overall, we found that the Medicaid expansions were linked to 2,840 deaths prevented each year across the three states, with the benefits of coverage greatest for older adults (ages 35-64), non-whites, and those living in poorer counties.
As states approach 2014 and weigh whether to expand Medicaid, there are numerous factors to consider, including cost (though the federal government will pay the full costs for newly-eligible adults for three years and 90% in the long run) and impact on the health care system in general. One would certainly think that the impact of Medicaid on access and health among those it covers should be a key consideration.
My talk will focus on how we did our study, the main findings, and the policy implications. I am very much looking forward to hearing from Dr. Heidi Allen, who will present findings on a similar topic from their ground-breaking study of a randomized trial in Oregon’s Medicaid program. Our papers complement each other nicely and hopefully will inform Georgia’s ongoing policy discussion about whether or not to expand Medicaid under the ACA.
See you in October. Register now.
Dr. Sommers is a health economist and physician whose primary research interests are the uninsured, Medicaid, and medical decision-making. Dr. Sommers authored a landmark study, recently published in the New England Journal of Medicine, which found Medicaid expansions to be associated with lower state death rates.