“Our estimates suggest that approximately 15,600 deaths would have been averted had the ACA expansions been adopted nationwide as originally intended by the ACA,” Sarah Miller, Sean Altekruse, Norman Johnson, and Laura R. Wherry wrote in the NBER study.

The study examined the mortality rates among low-income people aged 55 to 64 in states that opted to expand Medicaid under the ACA and those that did not.

When the ACA became law, states had the option of expanding Medicaid eligibility to nearly all low-income people, with the federal government covering nearly all the cost, according to the Kaiser Family Foundation. Still, 14 states from Georgia to Florida to Texas — all with either Republican governors, Republican legislatures, or both — refused to do so.

According to the study, more than 13.5 million people were able to obtain health insurance in the states that embraced the Medicaid expansion. “Our analysis provides new evidence that Medicaid coverage reduces mortality rates among low-income adults,” the authors wrote.

In a state like Texas, the decision to refuse the Medicaid expansion meant approximately 750,000 people were forced to live without a viable health insurance option, even though one could have been available to them under the ACA.

In May 2013, then-Gov. Rick Perry dismissed expanding Medicaid as “foolish,” saying, “Texas will not be held hostage by the Obama administration’s attempt to force us into this fool’s errand of adding more than a million Texans to a broken system.”

In 2015, Republican Gov. Greg Abbott reiterated his party’s position against Medicaid expansion, saying, “Medicaid expansion is wrong for Texas.”

The decision does not sit will with all Texas residents.

“It felt like in Charles Dickens’ A Christmas Carol when Scrooge says, ‘Let them die and reduce the surplus population,'” Tanya Walker told the Texas Tribune in 2018 about her state’s refusal to expand Medicaid eligibility. “That’s how I felt other Texans and my legislators felt about the working poor, ‘If you can’t afford insurance then we don’t care about you.'”

And Texas politicians are not only refusing to expand Medicaid in their own state, but trying to rip away health care from millions in other states as well. Texas is leading a multi-state lawsuit seeking to declare the entire ACA unconstitutional.

If the GOP-led lawsuit is successful, the entirety of the Medicaid expansion would go away, leaving millions without sufficient access to health care.

And based on the results of the NEBR study, that outcome could be deadly for tens of thousands of low-income Americans.

Published with permission of The American Independent.