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The 25 GOP-led states that are refusing to expand Medicaid as part of the Affordable Care Act are not just turning down an estimated $42.6 billion in 2014 alone, they’re also missing a chance to save 27,000 lives — according to a new study from the pro-expansion group Health Care for America Now (HCAN).

HCAN’s projection is based on a Harvard School of Public Health study published in 2012 in the New England Journal of Medicine that compared states that had expanded Medicaid to childless adults to those who hadn’t:

The mortality rate in expansion states was 6.1 percent lower than in the neighboring expansion states. For every 500,000 adults gaining Medicaid benefits, 2,840 deaths would be prevented each year, the researchers found. Put another way, for every 176 people added to the Medicaid rolls, one life would be saved.

An estimated five million residents of states that haven’t expanded the program will find themselves in a “coverage gap,” where they will neither qualify for Medicaid nor be able to afford a policy in the insurance exchanges. Applying that 1-in-176 formula to five million uninsured, HCAN comes up with the 27,000 lives that may be lost.

The report also estimates how many jobs would be created by the expansion, which is entirely funded by the federal government for three years, tapering down to 90 percent by the end of the decade. In Texas, where 1 in 4 residents are uninsured, not only could nearly 6,000 lives be saved by expansion, but 300,000 jobs could be created by adding $67.9 billion a year in economic activity.

Instead of accepting new economic growth, states are putting their most vulnerable hospitals at risk of closing.

Expansion was designed to make up for the reduced fees for care mandated by the Affordable Care Act, which was written with the assumption that states would only be able to opt out of expansion if they rejected Medicaid funding entirely. The Supreme Court ruled in 2012 that states could reject the expansion without any consequence. They can also opt in and out of the program as they choose to.

The federal government has been lenient with Republican states that decide to expand Medicaid. Arkansas is implementing a “private option” for the program that may be duplicated by Iowa.

“In Florida, [Latinos] make up 27 percent, and in Texas they make up 47 percent. Texas has the highest rate of uninsured in the country. The majority of people there who are going to miss out on care — over 60 percent — are black and Latino,” The Atlantic‘s Ta-Nehisi Coates wrote.

Noting the disproportionate effect on minorities, the report finishes with a rhetorical explosion that conjures memories of the battle to end segregation and connects it to the widespread right-wing lie that the Affordable Care Act includes “death panels.”

“Now in 2013, it turns out that the only real death panels consist of governors and lawmakers standing in the doorway of state Medicaid expansion, blocking access to health care for nearly 5 million Americans.”

Click ahead to see how many lives could be saved in each state.

Photo: Ed Schipul via Flickr


Projected Lives Saved by Medicaid Expansion in Current  Non-Expansion States, Based on Sommers, Baicker, and  Epstein’s Harvard School of Public Health Study

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