Get This: Having Healthcare…Might Make People…Healthier?

As if there weren’t already a million reasons to be constantly furious at the legislators and governors in states that have refused to expand Medicaid, here’s another one: there’s a growing body of evidence to support the conclusion that having healthcare makes people—wait for it—healthier.

The Washington Post’s Amy Goldstein reported Monday on several studies looking at different pieces of this very question. See if you can detect a theme:

It is difficult to prove conclusively that the law has made a difference in people’s health, but strong evidence has emerged in the past few years. Compared with similar people who have stable coverage through their jobs, previously uninsured people who bought ACA health plans with federal subsidies had a big jump in detection of high blood pressure and in the number of prescriptions they had filled, according to a 2018 study in the journal Health Affairs.

And after the law allowed young adults to stay longer on their parents’ insurance policies, fewer 19- to 25-year-olds with asthma failed to see a doctor because it cost too much, according to an analysis of survey results published earlier this year by researchers at the Centers for Disease Control and Prevention.

[…]

One 2017 study compared heart surgery patients in Michigan and Virginia, which had not yet expanded Medicaid at the time. It found that those who had cardiac bypasses or valve operations in Michigan had fewer complications afterward than similar people in Virginia, where more were uninsured.

One in three Michigan women said that, after joining Medicaid, they could more easily get birth control. And four in 10 people in Healthy Michigan with a chronic health condition — such as high blood pressure, a mood disorder or chronic lung disease — learned of it only after getting the coverage, according to survey results published last month.

The whole story is worth a read; in addition to covering the more wonky research behind this, it does a good job highlighting how Healthy Michigan (that state’s Medicaid plan) has helped save lives since the state expanded Medicaid under the Affordable Care Act. (Michigan, unfortunately, is set to subject nearly half of its enrollees to work requirements, after Republicans in the state passed a law last year doing just that.)

Not everyone is so lucky; the Kaiser Family Foundation’s latest numbers say that at least nearly 4.9 million people who don’t have healthcare would have healthcare if the 14 states they live in would expand Medicaid. (This doesn’t count the people who’ve lost Medicaid because their states introduced work requirements.) The fact that these states haven’t is borderline criminal.

Interestingly enough, Goldstein pointed out that, so far, “the ACA’s supporters have not taken political advantage of the signs that the law is translating into better health.” As the Post pointed out in a different piece published today (emphasis mine):

Instead, Democrats have centered their rallying cries on the effort from President Trump and the GOP to undermine the health-care law, attacking Republicans over the lawsuit filed by more than a dozen GOP-led states that seeks to overturn the ACA. Democrats have also pointed to the administration’s push for skimpy, inexpensive health plans that eschew ACA requirements. Meanwhile, others in the party, including a number of 2020 Democratic presidential candidates, have called for even more sweeping changes to the nation’s health-care system, proposing Medicare-for-all.

There’s reason to believe that these two things are related. To start, just coming out and admitting that giving people free healthcare was one of the most useful and best parts of the Affordable Care Act raises significant questions about why everyone shouldn’t be entitled to the same benefit. Second, it points to an inadvertent failing of the ACA caused by the Supreme Court’s ruling in NFIB v. Sebelius: Not everyone is getting it. Further, the push by states to tack on work requirements to their Medicaid programs is a case study in why it’s not such a great idea to let states fuck around with people’s healthcare.

What if we took the best part of the ACA, improved it, and gave it to everyone? If defenders of mostly keeping the ACA in place the way it is aren’t going to pick up this mantle, then it might not be the worst thing for Medicare for All advocates to take it from them and reframe the debate.