Medicaid expansion saves lives

By Sheldon Weisgrau | Dec. 2, 2019

As we dive into the details of various Medicaid expansion proposals and advocate for the best possible plan for patients, it’s easy to lose sight of the basics. In addition to the economic benefits to the state, improved financial stability for families and enhanced prospects for rural hospitals, one fundamental truth underlies our efforts to expand KanCare: Medicaid expansion saves lives!

A new study for the National Bureau of Economic Research makes this clear. The study compares mortality rates of low-income adults ages 55 to 64 in states that have expanded their Medicaid programs and states that have not.1 The results are striking.

Prior to Medicaid expansion, mortality among low-income older adults was similar in all states examined by the researchers. But starting in 2014, the first year of Medicaid expansion, mortality rates started heading in opposite directions in expansion and non-expansion states. The annual mortality rate for low-income adults ages 55-64 fell by about 9 deaths per 10,000 people in expansion states compared to non-expansion states. The impact grew over time and by the fourth year of Medicaid expansion, the difference was about 21 deaths per 10,000 people.2

These differences are sizable, amounting to more than 19,000 lives saved among older adults in expansion states over these four years, and more than 15,000 lives lost in non-expansion states. Applying these findings to the Kansas population shows 288 lives lost from 2014-2017 as a result of the state’s failure to expand KanCare.3

This study, by respected researchers from the University of Michigan, National Institutes of Health, U.S. Census Bureau and University of California-Los Angeles, is the latest in a large and growing body of research on the positive health effects of Medicaid expansion. Just a sample of studies completed previously showed:

  • Declines in mortality for all causes, with the largest reductions for causes responsive to health care interventions, such as HIV-related mortality, as a result of Medicaid expansion4;
  • Greater improvement in infant mortality rates, especially among African-American infants, in expansion states5;
  • Lower mortality from cardiovascular disease in middle-aged adults in expansion states6;
  • Lower mortality for patients living with end-stage renal disease in expansion states7; and
  • Increases in colorectal cancer screening, diagnoses, and survival in patients with Medicaid in Kentucky, one of the first expansion states.8

These data show that Medicaid expansion is one of the most effective public health interventions ever implemented, on par in terms of lives saved with the introduction of seat belts.9 Kansans have waited long enough. Every day of delay in expanding KanCare will be measured in reduced health outcomes and increased deaths. It’s time to expand KanCare with no barriers and no delays.

1. Sarah Miller et al., “Medicaid and Mortality: New Evidence from Linked Survey and Administrative Data,” National Bureau of Economic Research working paper, August 2019.
2. Matt Broaddus and Aviva Aron-Dine, “Medicaid Expansion Has Saved at Least 19,000 Lives, New Research Finds: State Decisions Not to Expand Have Led to 15,000 Premature Deaths,” Center on Budget and Policy Priorities, November 6, 2019.
3. Ibid.
4. Benjamin D. Sommers, “State Medicaid Expansions and Mortality, Revisited: A Cost-Benefit Analysis,” American Journal of Health Economics, July 28, 2017.
5. Chintan B. Bhatt, MBBS and Consuelo M. Beck-Sagué, “Medicaid Expansion and Infant Mortality in the United States,” American Journal of Public Health, January 18, 2018.
6. Sameed Ahmed M. Khatana et al., “Association of Medicaid Expansion With Cardiovascular Mortality,” JAMA Cardiology, June 5, 2019.
7. Shailender Swaminathan et al., “Association of Medicaid Expansion With 1-Year Mortality Among Patients With End-Stage Renal Disease,” Journal of the American Medical Association, December 4, 2018.
8. Tong Gan et al., “Impact of the Affordable Care Act on Colorectal Cancer Screening, Incidence, and Survival in Kentucky,” Journal of the American College of Surgeons, April 2019.
9. Broaddus and Aron-Dine.

Sheldon Weisgrau is the Alliance for a Healthy Kansas’ Senior Policy Advisor. Contact Sheldon at