BEYOND THE NUMBERS
The Affordable Care Act’s (ACA) Medicaid expansion has produced not only historic health coverage gains but other far-reaching positive effects as well, a large and growing body of research finds. That undercuts the recent statement of Seema Verma, Centers for Medicare and Medicaid Services (CMS) Administrator, that the coverage gains represent a “hollow victory of numbers covered.” For example:
- Medicaid expansion has improved low-income peoples’ financial health. Low-income adults in states that expanded their Medicaid programs have fewer and smaller unpaid medical bills, according to a recent National Bureau of Economic Research study. The chance of accruing new medical debt was 20 percent lower in expansion states, and expansion coverage lowered unpaid medical bills sent to collection agencies by $1.7 billion a year in the 19 expansion states studied. This study is the latest showing that Medicaid expansion improves people’s financial security.
- Medicaid expansion is critical for states fighting the opioid epidemic. Between 20 and 34 percent of Medicaid expansion beneficiaries in four expansion states studied by the Government Accountability Office used behavioral health services such as psychotherapy, diagnostic services, and prescription drugs to treat a mental health or substance use disorder. State officials said that expansion beneficiaries’ access to needed behavioral health care likely improved after enrolling in Medicaid.
- Medicaid coverage for parents improves their children’s access to care. Low-income children with parents enrolled in Medicaid are 29 percentage points likelier to get an annual well-child visit, according to research published in the American Academy of Pediatrics’ journal. Covering parents improves participation among unenrolled and uninsured children who are eligible for Medicaid and the Children’s Health Insurance Program, other research shows. That also means that efforts to cut enrollment among low-income parents, such as letting states impose a work requirement in Medicaid as CMS intends to do, will likely hurt kids by reducing their enrollment in coverage and limiting their access to care.
- Health insurance coverage has reduced the number of people in poverty. Health coverage — particularly public insurance like Medicare and Medicaid, and the ACA’s premium tax credits and cost-sharing reductions that help low- and moderate-income people afford coverage — reduced the poverty rate by nearly one-quarter in 2014, according to an analysis in Health Affairs that factors premium costs and the benefits of health insurance into the poverty rate. That equates to lifting more than 14.4 million people out of poverty.
Although no new states expanded Medicaid in 2017, at least one more state will likely adopt the expansion this year. For example, Maine lawmakers are working to implement the expansion after voters overwhelmingly approved a ballot initiative in November, and Virginia’s new governor has made Medicaid expansion one of his administration’s top priorities. Contrary to Administrator Verma’s false claims, policymakers in these and other states recognize Medicaid expansion’s many benefits for their residents.