Each week it seems like there is a new study that shows the benefits of expanding Medicaid—for both health and state budgets. When you couple the research with the new opportunity that non-expansion states have to infuse millions of federal dollars into their economies if they finally expand, it’s hard to comprehend why the last 12 non-expansion states have not yet jumped at the chance.
Health justice advocates in non-expansion states have long lifted up studies on the benefits of expansion for their policymakers and, since the passage of the American Rescue Plan, have brilliantly highlighted the new federal funding incentive to spark renewed interest in expansion among policymakers.
It’s changing the conversation in many states, like Wyoming, where policymakers who had previously been unwilling to move forward with a debate on expansion reconsidered, leading to the historic passage of a bill to expand Medicaid in the Wyoming House of Representatives. The narrow defeat of Wyoming’s Medicaid expansion proposal (and the chance that they might revisit the topic again this summer) highlights the importance of health justice advocates continuing the fight and uplifting the profound impacts on access to health care and health outcomes Medicaid expansion can bring to their states.
KFF conveniently consolidated a litany of studies related to the benefits of Medicaid expansion into a recently released literature review. These benefits span a wide spectrum:
Increased coverage and access to care among populations with cancer, chronic disease, and/or disabilities.
Access to Medicaid expansion meant that beneficiaries could receive earlier diagnoses and better address their conditions. In fact, most studies related to Medicaid expansion found an association between expansion and increases in early-stage diagnosis rates among cancer patients.
Improved overall mortality rates as well as improved mortality rates associated with some specific health conditions, such as various types of cancer, cardiovascular disease, and liver disease.
There has also been evidence that people experienced some protection from developing severe illness and death from COVID-19 because they were able to address and improve underlying chronic conditions such as diabetes, obesity, and lung and heart conditions.
Improvements in outcomes related to sexual and reproductive health.
When states expand their Medicaid program to close the coverage gap, there is an increase in the number of people who have Medicaid coverage both before and after they get pregnant and have babies—a time when health coverage is crucial for both parents and babies. Medicaid expansion has also improved access to care, increased the use of health services and led to better self-reported health among women of reproductive age, which could lead to healthier starts to pregnancies. Medicaid expansion also increased access to and utilization of more effective contraception methods. And lastly, studies reveal that expansion increased rates of HIV screening and diagnosis rates.
Improvements in access to care and outcomes related to substance use disorder (SUD) as well as other mental health care.
The COVID-19 pandemic and all of its negative impacts (e.g., job loss and isolation) have all contributed to poor mental health outcomes as well as elevated substance use trends. Medicaid expansion has served to provide access to needed treatments, including a range of treatments that became more accessible via telehealth methods during the pandemic.
Beneficial economic impacts on state budgets, hospitals, and other sectors.
States that have expanded Medicaid have experienced net savings by offsetting costs in other areas. Medicaid expansion has also improved the financial performance of hospitals and other health care providers through decreased uncompensated care costs. Additionally, more entrepreneurs and small-business employees have health coverage because of Medicaid expansion. In fact, 12 percent of previously uninsured individuals who are employed by small businesses found coverage through Medicaid. Small businesses have benefited from Medicaid expansion because they can focus on economic security while providing health coverage to employees.
A narrowing of racial inequities in coverage and certain health outcomes.
Since the Affordable Care Act, when Medicaid expansion became an option to states, there have been decreased racial inequities in coverage rates, affordability, utilization of health care services, and health outcomes.
Improvements in different social determinants of health.
This includes individual economic stability and access to care in rural areas.
Without necessary change—and Medicaid expansion is a big one—health inequities will persist. Now, health justice advocates have outcomes from the hundreds of studies that show the benefits of expansion in one place, along with the new federal funding, to call for Medicaid expansion. It’s up to their policymakers to listen.