NEW REPORT: Medicaid Expansion Has Averted an Estimated 369 Deaths a Year of Near-Elderly Low-Income Individuals in Pennsylvania

Diana Polson |

HARRISBURG – New evidence shows that 1,467 lives were saved in the four years since Medicaid was expanded in Pennsylvania. A new study released via the National Bureau of Economic Research (NBER)[1] that compares the death rates of the near-elderly population (ages 55-64) in states that have and have not expanded Medicaid found that expanding Medicaid in Pennsylvania in 2015 saved an estimated 369 lives a year or 1,467 lives in the four years following expansion.[2] Out of 31 states included in the study that have expanded Medicaid, Pennsylvania’s expansion has averted the second most number of deaths, second only to California.[3]

Overall, in states making the decision to expand Medicaid coverage through the Affordable Care Act the researchers found a reduction of mortality rates by 0.13% for low-income, near-elderly adults.

It has been well established that the annual mortality rate for low-income individuals is significantly higher than that of higher income individuals. For the near-elderly (aged 55-64) who earn less than 138% of the Federal Poverty Line, the annual mortality rate is 1.6%. This is nearly 2.3 times higher than the rate of higher income people of the same age (0.7%) . This group experiences much higher rates of dying from diabetes, cardiovascular disease and respiratory disease, all of which can often be mitigated with medication.

“The findings from this study are simple, yet so important. Access to Medicaid can help to reduce these disparities by ensuring low-income people have access to preventative care, life-saving prescription drugs, and early detection of disease, including cancer,” said Diana Polson, policy analyst for the PA Budget and Policy Center.

The study examined data before and after Medicaid expansion and found that, prior to expansion, states had similar trends in Medicaid coverage and mortality for this near-elderly population. After expansion, however, the coverage and mortality rates began to diverge. Each year after expansion, the probability of mortality declined significantly for this population in Medicaid expansion states, signaling that longer periods of health coverage results in improved health outcomes.

Not expanding Medicaid has had deadly consequences. Researchers estimate that 15,600 deaths between 2014 and the end of 2017 could have been avoided had states decided to expand Medicaid coverage. Recent efforts by the Trump administration threaten the future of the Affordable Care Act and Medicaid expansion in Pennsylvania and elsewhere. The U.S. Court of Appeals for the Fifth Court is reviewing a decision by the Northern District of Texas that would invalidate the entire Affordable Care Act because the individual mandate was eliminated in the 2017 Tax Cuts and Jobs Act.

[1] Sarah Miller, Sean Altekruse, Norman Johnson, Laura R. Wherry. “Medicaid and Mortality: New Evidence from Linked Survey and Administrative Data.” National Bureau of Economic Research, Working Paper Series, Working Paper 26081. July 2019.

[2] The authors of the report calculated these numbers by multiplying the population size that meets their sample criteria of each state by the average percentage point change (0.13%) in mortality rate associated with Medicaid expansion.

[3] A few states were excluded from the study because they had already expanded Medicaid eligibility prior to the passage of the ACA. These states are: Delaware, Massachusetts, New York, Vermont, and DC.