Obamacare Might be Making People—Especially Poor People—Healthier

by Joan McCarter –


The health impacts of a program like Obamacare are generally hard to measure in the short term and over a population as large as the United States’. But the Supreme Court unwittingly did researchers a favor by ruling that the Medicaid expansion part of the law could be optional among states. While Republican governors in many states screwed their citizens by refusing that expansion, they set up a perfect research opportunity, “a huge natural experiment” in the words of  Dr. Benjamin Sommers, as reported by The New York Times. He’s an author of a new study study published in JAMA last week. The Times summarizes:

Low-income people in Arkansas and Kentucky, which expanded Medicaid insurance to everyone below a certain income threshold, appear to be healthier than their peers in Texas, which did not expand. […]The researchers gathered their results by conducting a large telephone survey of low-income residents of the three states. They asked the same questions three times: in 2013, before the law’s Medicaid expansion; at the end of 2014, after it had been in place for a year; and at the end of last year. Then they compared what happened over time, using Texas as a kind of control group to see how much of a difference the Medicaid expansions in the other two states made.

Their survey found people in Arkansas and Kentucky were nearly 5 percent more likely than their peers in Texas to say they were in excellent health in 2015. And that difference was bigger than it had been the year before.

According to the Times, self-reporting is actually one of the most reliable measures of health outcomes. “Extensive research,” Margot Katz-Sanger reports, “shows that people who say they are in poor health really are much more likely to die than those who describe their health as good.” It’s just about the only reliable measure you can use in a time frame of a few years, because it’s not long enough to get a sense of morbidity and mortality trends, and there are limits to researchers’ ability to get actual medical records to evaluate. The survey also asked about access to care, and the people who obtained Medicaid in Arkansas and Kentucky reported they were more likely to have a doctor or a regular place to go for care, more likely to get treatment for chronic health problems,as well as more likely to have preventive screenings for things like heart disease and diabetes than their peers in Texas. They were also less likely to be struggling with medical debt, or to postpone care for financial reasons.

We won’t know for years what the impact on public health from Obamacare will be, but this study provides a tantalizing—and really encouraging—glimpse of that future.


Reprinted with permission from Daily Kos