The country’s lopsided income distribution is mirrored in its vital statistics. The top 1 percent of Americans by this measure live an average of almost 15 years longer than the bottom 1 percent, according to a study of tax and death records published last year in JAMA. Like income gains, health improvements have been concentrated at the top. From 2001 to 2014, life expectancy for men in the top 5 percent by income increased two years and four months; for women, by almost three years. In the bottom 5 percent, men gained fewer than four months, and women’s average life expectancy increased by just two weeks.
Some conservatives argue that expanding health insurance hasn’t been shown to improve health. In fact, having coverage wasn’t meaningfully linked to longer life expectancy in the JAMA analysis. A rigorous study in Oregon of people who were randomly selected to get Medicaid coverage failed to find gains in physical health over two years. Medicaid did, however, improve people’s mental health, leading to lower rates of depression. It also improved their finances, reducing out-of-pocket spending, medical debt, and catastrophic costs.
In Ohio, more than a million people have gotten Medicaid coverage over some period of time since 2014 under Obamacare. “Medicaid expansion is really about getting people ready to work,” says Ohio Medicaid Director Barbara Sears. Three-quarters of those newly covered who were looking for work said being on Medicaid made it easier to look for jobs. Moreover, a majority of those employed said having access to Medicaid helped them stay on the job, according to a state survey (PDF).
What’s the connection? Perhaps America’s opioid epidemic plays a role: Sears said she’s heard hundreds of stories of Ohioans struggling with addiction who were able to return to the workforce after getting treatment paid for by Medicaid.
“If I have a mental health or addiction issue, I may be able-bodied but not work-ready,” Sears said. She added that rolling back the expansion, which is funded mostly by the federal government, would trigger larger state expenditures under other, more expensive programs for the disabled.
Ohio’s Republican governor, John Kasich, has urged Senate Republicans to keep Obamacare’s protections for the poor. He and six other governors of both parties sent a letter to Senate leaders last month saying that the plan passed by the House, which is similar to the Senate plan, “calls into question coverage for the vulnerable and fails to provide the necessary resources to ensure that no one is left out, while shifting significant costs to the states.”
This article was provided by Bloomberg News.