Mortality and Access to Care among Adults after State Medicaid Expansions

The effect of Medicaid expansions on access and health outcomes was studied in New York, Maine, and Arizona. After expansions, there was a significant reduction in mortality as well as an increased rate of Medicaid coverage and a decreased rate of uninsurance. Medicaid currently insures 60 million people, and the Affordable Care Act (ACA) will extend Medicaid eligibility to millions more starting in 2014. 1 The recent Supreme Court ruling enables states to choose whether to expand Medicaid under the ACA, and many states facing budget pressures are considering cutbacks instead. 2 Yet evidence regarding Medicaid's effect on health remains surprisingly sparse, particularly for adults. Previous research showed that Medicaid expansions in the 1980s reduced mortality among infants and children, 3 , 4 though other studies showed little effect. 5 – 7 Numerous observational studies have documented a correlation between Medicaid coverage and adverse outcomes among adults, 8 , . . .