Improving Health Through Coverage Expansion
Authors: Austin Frakt
Journal: Annals of Internal Medicine (2014)

Editorials6 May 2014Improving Health Through Coverage ExpansionAustin Frakt, PhDAustin Frakt, PhDFrom Veterans Affairs Boston Healthcare System, Jamaica Plain, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-0379 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail How certain are we that health insurance reduces mortality rates?Weeks before the Patient Protection and Affordable Care Act (ACA) became law, a provocative column in The Atlantic (1) posed this question. It drew on an unrepresentative subset of the literature that failed to find an insurance–mortality relationship, including a 2009 study by Kronick (2). Others have asserted, on the basis of studies with designs inappropriate for causal inference, that Medicaid coverage causes worse outcomes than no coverage (3). Such claims that health insurance is not good for health have fueled political opposition to the ACA's subsidized coverage expansion, including nearly ...References1. McArdle M. Myth diagnosis. The Atlantic. 1 March 2010. Accessed at www.theatlantic.com/magazine/archive/2010/03/myth-diagnosis/307905 on 2 April 2014. Google Scholar2. Kronick R. Health insurance coverage and mortality revisited. Health Serv Res. 2009;44:1211-31. [PMID: 19453392] CrossrefMedlineGoogle Scholar3. Frakt A, Carroll AE, Pollack HA, Reinhardt U. Our flawed but beneficial Medicaid program. N Engl J Med. 2011;364:e31. [PMID: 21470001] CrossrefMedlineGoogle Scholar4. McWilliams JM. Health consequences of uninsurance among adults in the United States: recent evidence and implications. Milbank Q. 2009;87:443-94. [PMID: 19523125] CrossrefMedlineGoogle Scholar5. Baicker K, Taubman SL, Allen HL, Bernstein M, Gruber JH, Newhouse JP, et al; Oregon Health Study Group. The Oregon experiment—effects of Medicaid on clinical outcomes. N Engl J Med. 2013;368:1713-22. [PMID: 23635051] CrossrefMedlineGoogle Scholar6. Courtemanche CJ, Zapata D. Does universal coverage improve health? The Massachusetts experience. J Policy Anal Manage. 2014;33:36-69. CrossrefMedlineGoogle Scholar7. Van der Wees PJ, Zaslavsky AM, Ayanian JZ. Improvements in health status after Massachusetts health care reform. Milbank Q. 2013;91:663-89. [PMID: 24320165] CrossrefMedlineGoogle Scholar8. Sommers BD, Long SK, Baicker K. Changes in mortality after Massachusetts health care reform. A quasi-experimental study. Ann Intern Med. 2014;160:585-93. LinkGoogle Scholar9. Bond AM, White C. Massachusetts coverage expansion associated with reduction in primary care utilization among Medicare beneficiaries. Health Serv Res. 2013;48:1826-39. [PMID: 24117239] CrossrefMedlineGoogle Scholar10. McInerney M, Mellor JM. Recessions and seniors' health, health behaviors, and healthcare use: analysis of the Medicare Current Beneficiary Survey. J Health Econ. 2012;31:744-51. [PMID: 22898452] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Veterans Affairs Boston Healthcare System, Jamaica Plain, Massachusetts.Disclaimer: The views expressed in this article are those of the author and do not necessarily reflect the positions of the Department of Veterans Affairs.Acknowledgment: The author thanks Michael McWilliams for his comments on an early draft.Disclosures: None. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0379.Corresponding Author: Austin Frakt, PhD, Veterans Affairs Boston Healthcare System, 150 South Huntington Avenue (152H), Jamaica Plain, MA 02130; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoChanges in Mortality After Massachusetts Health Care Reform Benjamin D. Sommers , Sharon K. Long , and Katherine Baicker Changes in Mortality After Massachusetts Health Care Reform Benjamin D. Sommers , Sharon K. Long , and Katherine Baicker Metrics Cited ByThe Interconnected Relationships of Health Insurance, Health, and Labor Market OutcomesMortality falls in Massachusetts after healthcare reform 6 May 2014Volume 160, Issue 9Page: 649-650KeywordsDeath ratesElderlyHealth careHealth insuranceHealth surveysMedicareObservational studiesVeteran care ePublished: 6 May 2014 Issue Published: 6 May 2014 PDF DownloadLoading ...