A new study shows lack of Medicaid expansion in 14 states, including Kansas, has caused 15,600 deaths that likely would have been averted with full expansion. The study is the latest in a growing body of evidence that Medicaid expansion is a cost-effective way to provide health care to low-income Kansans.
Medicaid is the primary way low-income Americans, mostly children, receive health care. More than 400,000 Kansans are covered by Medicaid, also called KanCare, in Kansas. The program covers children, people with disabilities, pregnant women and the elderly. KanCare is also a major source of funding for many hospitals, nursing homes and other health care providers, particularly those operating in rural areas with thin margins.
An additional 150,000 Kansans fall into what advocates have called “the coverage gap,” making too much money to qualify for Medicaid but too little to afford private insurance. These Kansans are mostly the working poor, those employed in jobs that do not offer health insurance. More than 70 percent of uninsured Americans work in jobs not offering employer-funded insurance, and many of the remaining uninsured cannot afford their employer’s insurance, according to the Kaiser Family Foundation.
Expanding Medicaid would cover Kansans living in the gap, with the federal government covering 90 percent of costs.
In the absence of expansion, 150,000 Kansans remain uninsured, under-insured, or struggle to afford health care expenses. In the new study, a team led by Sarah Miller, of the University of Michigan, looked at mortality of low-income residents in states that did and did not expand Medicaid. The authors also explore data on health care outcomes for low-income Americans covered by Medicaid. Their results are compelling.
Compared to similarly situated low-income Americans, those covered by Medicaid are more likely to use prescription drugs, including medications used to manage diabetes, HIV, hepatitis and heart disease, and those that help patients quit smoking. Medicaid expansion states have documented increases in cancer screening, early cancer detection and surgeries for treatable cancers.
Medicaid coverage also increases doctor visits, routine screening for chronic illnesses and dental care.
Given the data, it is not surprising that when the study’s authors looked at government mortality data, they found “small but statistically significant” decreases in mortality when comparing expansion and nonexpansion states. They estimate 15,600 deaths could have been averted if all states had expanded Medicaid as intended in the ACA.
This research is persuasive, but we have had plenty of prior evidence that Medicaid expansion is smart policy for Kansas. Expansion would trigger a $700 million annual investment of federal dollars, a massive infusion into our health care system in a state where at least three rural hospitals have closed in recent years and many more are at risk. Medicaid expansion helps reduce health care debt, which is the leading cause of bankruptcy in America.
Most importantly, expansion would help our hard-working friends and neighbors afford health care for themselves and their families.
Most Kansans favor Medicaid expansion. It just makes sense for Kansas.