Study: Medicaid expansion would have saved $190M, 220 lives

Medicaid expansion would have brought an additional $1.77 billion in federal spending and a $190 million reduction in uncompensated care, according to a new federal study.

The report, released Thursday by the White House Council of Economic Advisers examines the health and economic impact on the 22 states that did not expand Medicaid programs, including Tennessee.

Gov. Bill Haslam proposed Insure Tennessee, a plan to use Medicaid expansion funding to help provide insurance to 288,000 low-income Tennesseans. The plan, which Haslam didn't consider traditional Medicaid expansion, was twice defeated in state Senate committees.

The study used economic and health policy analyses from more than four dozen reports and papers to look at impacts on health, consumers and economies. Oregon's Medicaid lottery system, which limits the number of people who can enroll, is also evaluated.

"That evidence, which is based primarily on careful analysis of the effects of past policy decisions, is necessarily an imperfect guide to the future, and the actual effects of Medicaid expansion under the Affordable Care Act could be larger or smaller," according to the report. "But this evidence leaves no doubt that the consequences of States' decisions are far-reaching, with major implications for the health of their citizens and their economies."

It touches on the health impact of expanded coverage, estimating an additional 26,100 people would get cholesterol screenings in 2016, with an additional 40,000 undergoing a mammogram.

Regular contact with a health care provider is the best way to change behaviors that lead to chronic disease, noted Ralph Schulz, president and CEO of the Nashville Area Chamber Commerce, which released a pilot study this week about workforce health in greater Nashville.

The majority of people who qualify for Insure Tennessee, 62 percent, are working adults who do not have jobs that offer insurance or who cannot afford employer-sponsored coverage.

A Medicaid expansion program would bring with it an additional 483,000 visits to physicians a year, according to the report, which estimates 20,000 people would have received all needed care in the last year.

The report projects 220 fewer annual deaths.

Supporters of Insure Tennessee continue to push the issue to the forefront. State Democrats last week called for a second special session to take up the proposal.

Accessing coverage via Insure Tennessee would likely help many with high medical bills. In Tennessee, nearly one in three people struggle with medical debt — a number that tops the national average.

Medical debt impacts both patients and providers. A patient's credit score can be negatively impacted by outstanding bills; medical debt is one of the leading causes of personal bankruptcy.

For hospitals, unpaid bills add up. Tennessee hospitals provided $2 billion in charity care in 2013.

Reach Holly Fletcher at 615-259-8287 or on Twitter @hollyfletcher.