Revisiting the Health Effect of ACA Expansion
In your editorial 'The Medicaid Scare Campaign' (May 27), you refer to our research on the health effect of the ObamaCare Medicaid expansion among states as an honest but flawed effort. You suggest that a secondary finding in our study—smaller effects in a broader sample that included disabled individuals—undermines its conclusions. You add that it is 'clear that the ObamaCare expansion hasn't reduced deaths among lower-income, able-bodied adults,' citing flat U.S. life expectancies since 2014 as evidence. We respectfully disagree with both points.
Our research shows that Medicaid significantly reduced mortality among nondisabled, low-income adults who gained eligibility through the Affordable Care Act and earlier state expansions. That we find smaller effects in a broader sample that included disabled individuals—defined as Disability Insurance or SSI recipients—strengthens our argument: We wouldn't expect ACA eligibility expansions to increase coverage or reduce mortality among disabled individuals who were already eligible for Medicaid or Medicare. In our paper, we emphasize the results for the population of nondisabled, low-income adults precisely because this is the group targeted by the expansions. The inclusion of people with disabilities reduces the effect of the Medicaid expansions that is otherwise observed for this targeted group.
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