A new study reveals that low-income adults living in Southern states with expanded Medicaid programs under the Affordable Care Act (ACT) experienced less decline in mental and physical health. This was particularly true for those with severe mental and physical limitations.
“The effect is sizable and would amount to the worst-ranked Southern state rising about halfway up the rankings in state population health if it expanded Medicaid,” said J. Michael McWilliams, M.D., Ph.D., senior author and Harvard Medical School Professor of Health Care Policy.
“Unlike many other studies, we were able to focus on some of the most vulnerable populations who stand to gain the most from insurance coverage.”
The new study, published in the journal Health Affairs, drew on data on 15,536 low-income individuals recruited predominantly at community health centers in 12 Southern states as part of the Southern Community Cohort Study.
The findings add new evidence to state-level debates over the merits of expansion, including the question of whether access to safety net programs can serve as an adequate substitute for health insurance coverage.
“Our study is the first to consider the pathways through which, and populations for whom, expanded access to Medicaid affects the health trajectory of low-income adults,” said lead author John Graves, Ph.D., associate professor of Health Policy at Vanderbilt University School of Medicine (VUSM) in Nashville, Tenn.
“It fills an important gap between research that has found little evidence of health effects and other research demonstrating that expanded Medicaid saved lives.”
Of the 14 states that have not yet expanded Medicaid, nine are in the South and two border the region.
“Our research demonstrates that access to the safety net is an inadequate substitute for coverage, and that non-expanding Southern states could materially improve population health if they accept expansion funds,” Graves said.
“Health care policy experts and physicians have suspected this for a while but with our study, we now have the actual evidence showing that non-expanding Southern states could materially improve population health if they accept expansion funds.”