Preventable Deaths Declined More in Medicaid Expansion States

16 Pages Posted: 16 Jun 2020

See all articles by Brandon W. Yan

Brandon W. Yan

University of California, San Francisco (UCSF) - Institute for Health Policy Studies; University of California, San Francisco (UCSF) - School of Medicine; Duke University - Sanford School of Public Policy

Felicia Guo

Duke University - Trinity College of Arts & Sciences

Frank A. Sloan

Duke University - Center for Health Policy, Law and Management; Duke University, Fuqua School of Business-Economics Group; Duke University - Department of Economics; National Bureau of Economic Research (NBER)

R. Adams Dudley

University of California, San Francisco (UCSF) - Institute for Health Policy Studies

Date Written: November 20, 2019

Abstract

The Affordable Care Act’s (ACA) expansion of Medicaid in 2014 has improved access to care, but data on its impact on health and mortality is limited. In this study, we use U.S. mortality data from 2011 to 2017 to analyze trends in mortality among adults ages 25-64 before and after Medicaid expansion. We analyze both all-cause mortality and mortality from causes considered amenable to health care and compare states that did and did not expand Medicaid. We found that while all-cause mortality rose steadily for non-elderly adults between 2013 and 2017, health care amenable mortality fell 68% more (-3.70% vs. -2.20%) in states that expanded Medicaid compared to those that did not. Although trends varied widely by state, Medicaid expansion states comprised 13 of the 15 states with the largest reductions in health care amenable mortality. The data suggest that Medicaid expansion may have prevented premature deaths during a period of rising overall mortality.

Keywords: health care reform, Medicaid, health disparities, insurance coverage, utilization, preventive care, Affordable Care Act, health care amenable mortality

JEL Classification: I13, I14, I18, H75, H51

Suggested Citation

Yan, Brandon W. and Guo, Felicia and Sloan, Frank A. and Dudley, R. Adams, Preventable Deaths Declined More in Medicaid Expansion States (November 20, 2019). Available at SSRN: https://ssrn.com/abstract=3607686 or http://dx.doi.org/10.2139/ssrn.3607686

Brandon W. Yan (Contact Author)

University of California, San Francisco (UCSF) - Institute for Health Policy Studies ( email )

3180 18th St., Suite 302
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University of California, San Francisco (UCSF) - School of Medicine ( email )

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Duke University - Sanford School of Public Policy ( email )

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Felicia Guo

Duke University - Trinity College of Arts & Sciences ( email )

117 Physics Building
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Frank A. Sloan

Duke University - Center for Health Policy, Law and Management ( email )

Box 90253
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United States
919-684-8047 (Phone)
919-684-6246 (Fax)

Duke University, Fuqua School of Business-Economics Group ( email )

Box 90097
Durham, NC 27708-0097
United States

Duke University - Department of Economics ( email )

213 Social Sciences Building
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Durham, NC 27708-0204
United States

National Bureau of Economic Research (NBER)

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R. Adams Dudley

University of California, San Francisco (UCSF) - Institute for Health Policy Studies ( email )

3180 18th St., Suite 302
San Francisco, CA 94110
United States

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