September 22, 2019
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LePage should try arguing against saving people’s lives

Charles Dharapak | AP
Charles Dharapak | AP
Republican presidential candidate, former Massachusetts Gov. Mitt Romney, speaks about the Supreme Court's health care ruling in Washington in June 2012. Millions of uninsured Americans may have to wait until after Election Day to find out if and how they wi’ll be able to get coverage through President Barack Obama'’s health care overhaul because many governors from both parties said they haven'’t decided how their states will proceed on two components under their control: an expansion of Medicaid, and new insurance exchanges.

The argument against extending Medicaid in Maine and other states under the Affordable Care Act has largely centered on money and state’s rights. What has not been discussed until recently is that the expansion could save lives.

A study by Harvard researchers, published Wednesday by The New England Journal of Medicine, found that when more poor people had health insurance, fewer people died. Part of the research was conducted in Maine. If that doesn’t add another good reason to the argument about why the state should cover more vulnerable populations, we’re not sure what does.

The U.S. Supreme Court ruling on the president’s health care law gave states the flexibility to decide themselves whether to expand Medicaid. The expansion of the program is a major part of how the health care overhaul plans to extend coverage to about 30 million uninsured people.

Gov. Paul LePage said a final decision about whether to expand Medicaid in Maine will be made after November elections, but he has spoken harshly against the law and the expansion.

And his administration is continuing to argue in favor of making $10 million in Medicaid cuts that Republican legislators approved in May. That’s the case even though the secretary of the U.S. Department of Health and Human Services and the nonpartisan Congressional Research Service said states may not scale back their existing Medicaid services.

It would be wise for the administration to move beyond political preference and make a decision based on data. The study by Harvard’s School of Public Health analyzed data from New York, Arizona and Maine, all of which expanded their Medicaid programs within the last decade to cover people not normally eligible: low-income adults without children or disabilities.

The study collected the mortality rates of the three states from both the five years before and after the Medicaid expansions and compared them to those in four neighboring states — Pennsylvania, Nevada, New Mexico and New Hampshire — that had not had expansions.

The study adjusted for population growth and found that the number of deaths for people age 20 to 64 decreased in the three states by about 1,500 per year. It estimated the Medicaid expansions were associated with one life saved for every 176 new people who got coverage. Mortality reductions were greatest among older adults, nonwhites and residents of poorer counties.

The report concluded, “State Medicaid expansions to cover low-income adults were significantly associated with reduced mortality as well as improved coverage, access to care, and self-reported health.”

Any study has limitations, including this one. The figures are county-level statistics, not individual deaths. And it’s hard to know whether the same results could be applied to each state. But another study in Oregon so far shows similar results: Medicaid recipients report better health and see doctors more often.

There are many reasons to support the federal health care law: It insures those with pre-existing conditions, eliminates lifetime dollar limits on benefits, provides more free preventive services, re-aligns the spending of health insurance companies to focus more on patient care and provides a clearinghouse of health insurance plans, so people can pick the best one for them.

The law is projected to shrink the federal deficit, according to the nonpartisan Congressional Budget Office. (Repealing the law would increase the deficit $109 billion from 2013 to 2022).

It could also save thousands of lives. Isn’t that worth fighting for?

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