A new paper published by the National Bureau of Economic Research looked into the effects of the Affordable Care Act’s Medicaid expansion to people below 138 percent of the poverty line, which has seen nearly 15 million people enrolled in participating states. The results were encouraging: the mortality rate for near-elderly adults has dropped over 9 percent in the four years for which data is available.
But while this is cause for celebration, The Atlantic staff writer Annie Lowrey offered a darker take on the implications of these numbers:
One way to read this: The Supreme Court allowing states to opt out of the Medicaid expansion killed nearly 16,000 people. https://t.co/KKIsnIMWh3
— Annie Lowrey (@AnnieLowrey) July 22, 2019
Lowrey is referring to the Supreme Court’s 2012 decision in National Federation of Independent Businesses v. Sebelius, the landmark case that decided whether key parts of the ACA were constitutional.
The Court famously ruled that the individual mandate to purchase health insurance was constitutional, with conservative Chief Justice John Roberts casting the deciding vote — but the Court also struck down the part of the law that let the federal government take punitive action against states that decline to expand Medicaid. This left the door open for Republican governors and legislatures to block Medicaid expansion in their states, which many did.
While some of the initial holdouts have since joined the expansion, like Louisiana, Maine, and Virginia, many states went years without covering tens of thousands of low-income adults, and some still haven’t moved to expand Medicaid at all.
The Supreme Court could well cause tens of thousands more deaths if it decides to uphold the Texas lawsuit trying to throw out the entire ACA, which is currently being considered by the Fifth Circuit Court of Appeals.