The expansion of the Medicaid program through former U.S. President Barack Obama's Affordable Care Act has been linked to fewer deaths caused by heart conditions.
Researchers found that between 2010 and 2016, counties, where Medicaid was expanded, saw lower mortality for cardiovascular-related incidents. The findings add evidence to the claim that the presence of health insurance has an influence on death rates.
Lower Risk Of Heart-Related Deaths
The new research used data from 2010 to 2016 in all states except Massachusetts and Wisconsin, two stated where the Medicaid expansion was not covered by the ACA. The researchers analyzed the deaths associated with cardiovascular conditions in every state before and after the expansion. They then adjusted the differences based on factors that might affect the findings.
They discovered that cardiovascular deaths rose from 141.0 to 142 per 100,000 people in counties where the Medicaid coverage was expanded. In comparison, in non-expansion states, the cardiovascular deaths rose from 176.1 to 180.6 per 100,000 people.
Enrollments for insurance under the ACA began in 2014. As of 2016, 29 states, excluding Massachusetts and Wisconsin and the District of Columbia, have an expanded Medicaid coverage.
Limitations Of The Study
The researchers, however, admitted that there are certain limitations to the study. For one, the data was observational and, therefore, did not identify the factors that might have contributed to the lower death rate.
The team also said that the study did not distinguish between cardiovascular diseases.
"Another [limitation] is that we looked at cardiovascular diseases as a whole, so we sort of lumped everything together: heart attack, stroke, arrhythmias, et cetera," said Sameed Khatana, first author of the study. "Because any one cause of death causes very few deaths in individual counties, which was our level of analysis, we're not able to say which specific disease is responsible for these changes."
In addition, Olena Mazurenko, who authored a similar study on Medicaid last year, warned that the expansion occurred fairly recently. Its long-term impacts on public health are still not observed.
Georges Benjamin, executive director of the American Public Health Association, argued that the findings prove that providing insurance can decrease the mortality rate.
"[I]f you think about the fact that cardiovascular disease is the leading cause of death, followed by cancer, it would not be surprising that the leading cause of death goes down when you give people health insurance," he stated. "We know very clearly that again, even in the Medicaid program, that if you give people coverage, mortality goes down."
The findings were presented at the American Heart Association's Scientific Sessions on Friday, April 5.