Health Insurance Coverage and Health — What the Recent Evidence Tells Us
In a recent New England Journal of Medicine article, Dr. Atul Gawande and colleagues analyzed more than forty studies to assess the impact of health insurance coverage and health. According to Dr. Gawande in an email he sent to Ariadne Labs:
"The paper comes out as the U.S. Senate leadership prepares to release its proposal to repeal the Affordable Care Act. The central upshot: we found there is strong evidence that expansions in health coverage have improved people’s access to care and health across multiple domains of well-being and reduced deaths overall.
Here are twelve of our specific findings:
1. People are more likely to have a usual source of medical care and to be able to afford the medical care they need.
2. Fewer medical bills are sent to collections and bankruptcies. Catastrophic out-of-pocket expenses are virtually eliminated.
3. People have greater access to primary and preventive care, chronic illness treatment, and medications.
4. 15-30% more people get screened for high cholesterol and cancer.
5. Nearly twice as many patients take necessary diabetes medication.
6. Depression symptoms (leading cause of disability in US) are reduced by 30%, and more people are diagnosed successfully.
7. More low-income patients get necessary surgery for colon cancer BEFORE it's too late.
8. Result: 25% more people report being in good or excellent overall health.
9. Longest study: gaining Medicaid cut mortality by 6% over 5 years. The biggest gains came from treatable conditions like heart disease, cancer, and infection.
10. The longer people have coverage, the greater the mortality reduction.
11. Overall, for every ~300 to 800 adults who get coverage, we save one life per year.
12. Increasing coverage through Medicaid has been at least as effective as doing so through private insurance.
Our conclusion: Coverage expansion has made people healthier and helped tens of thousands per year live longer, healthier lives. Weakening coverage will increase medical debts, untreated sickness, and deaths.
As the national debate over the Affordable Care Act reaches this critical point, I hope that this study provides policymakers with a clear understanding of the serious implications of terminating insurance benefits and provides guidance for those whose goals are to prevent wide scale harm to population health and survival."
Please share these findings with your policymakers.