Medicaid Expansions Saved Tens of Thousands of Lives, Study Finds

As Congress eyes sweeping cuts to Medicaid, the health care program for low-income adults that serves about 20% of people living in the U.S., a new study has a sharp conclusion: cuts to Medicaid will cost lives.

The study, published in the National Bureau of Economic Research on May 5, tracked nearly 40 million people who gained Medicaid through state-based expansions under the Affordable Care Act between 2010 and 2022. It found that during that time, Medicaid expansions increased enrollment and reduced members’ risk of death by 2.5%.

People who enrolled in Medicaid because they gained eligibility saw a 20% reduction in their risk of death when compared to people in states who could not access Medicaid, the study found. In short, Medicaid expansions saved about 27,400 lives between 2010 and 2022, according to the study, by Dartmouth economics professor Angela Wyse and University of Chicago economics professor Bruce D. Meyer. 

It might seem obvious that expanding access to health insurance will improve people’s health. But academics have actually had a difficult time proving this, Wyse says.

“This study really does a lot to advance our understanding of the magnitude of this relationship between health insurance and this really important health outcome,” she says.

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Medicaid expansion saves lives because it allows people to see doctors and access preventative care, and get recommendations from doctors about how to improve their lifestyles, she says. 

The study is one of the largest to date showing the health impacts on expanding Medicaid. It also found that gaining access to Medicaid reduced the chance of death across demographics.

Its conclusion is especially relevant as Congress seeks to cut $600-$800 million from the Medicaid program over the next decade. Though around 70 million Americans are enrolled in Medicaid, the numbers vary tremendously by state. That’s because the Affordable Care Act, also known as Obamacare, allowed states to expand Medicaid to more people, offering some funding for them to do so. 

Forty-one states—including conservative ones like Arkansas, Oklahoma, and Louisiana—have expanded Medicaid in the years since the 2010 passage of the Affordable Care Act. But 12 states have trigger laws in place that would automatically end the Medicaid expansion, or that would require significant changes to the program should there be reductions to the amount of money the federal government provides. 

Potential cuts to Medicaid are extremely controversial; an April KFF poll found that 76% of the public opposes major cuts to Medicaid. Even some Republicans seem wary of approving cuts. In April, 12 conservative members of Congress wrote a letter to GOP leaders reiterating their support of Medicaid. “We cannot and will not support a final reconciliation bill that includes any reduction in Medicaid coverage for vulnerable populations,” the letter concluded. 

The study also found that Medicaid is a relatively cost-effective way to save lives. It cost only about $5.4 million per life saved, which is actually relatively low compared to other interventions, Wyse says. 

“I feel pretty confident in saying that restricting Medicaid access is going to have the real human cost of having more people die than otherwise would have,” she says.