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Monday, December 09, 2019 {{ new Date().getDay() }}

By Noam N. Levey, Tribune Washington Bureau

WASHINGTON — Expanding the number of young adults with health insurance appears to have improved their health and saved them money, according to a new study that is among the first to measure the effect of the health care law that President Barack Obama signed four years ago.

Starting in 2010, the Affordable Care Act allowed adults under age 26 to remain on their parents’ health plans, the first coverage expansion to take effect under the law.

Previous surveys have indicated that this provision, which remains among the law’s most popular, allowed millions of young adults to get health insurance over the last several years.

The new study, published in the Journal of the American Medical Association, suggests the coverage expansion also measurably increased the number of young adults who reported that they are in excellent physical and mental health.

Researchers also found a significant drop in how much young people were paying out of pocket for their medical care after the law went into effect.

“The health insurance that people are gaining seems to be doing what it is supposed to do,” said Dr. Kao-Ping Chua, a pediatrician at Boston’s Children’s Hospital and the lead author of the study.

The question of whether giving people insurance makes them healthier, in addition to protecting them against financial risk, has remained controversial as debate over the federal health law rages. The new research from Harvard University adds to growing evidence about the positive effects of insurance.

Last month, a study of Massachusetts’ trail-blazing 2006 health law found a decline in mortality rates after the state began guaranteeing health insurance. That study’s lead author, Dr. Benjamin Sommers, also co-authored the new paper.

In the study of young adults, researchers used survey data from the federal Agency for Healthcare Research and Quality to compare the experiences of young adults, ages 19 to 25, who were eligible for coverage under the law, to those 26 to 34, who were not. The study covered the eight years before passage of the health law and one year after.

Insurance coverage increased markedly among the young adults, while declining slightly among the older group.

At the same time, young adults’ annual out-of-pocket medical expenses, including copays and deductibles, declined from an average of $546.11 in the period before the health law to $490 in 2011.

By contrast, annual out-of-pocket medical costs for the older group increased from an average of $626.66 to $644.82.

Younger adults also reported feeling better, with nearly 31 percent reporting themselves in excellent physical health after passage of the law, compared to nearly 27 percent giving that rating before.

The older group experienced a decline in self-reported health, with 21 percent reporting excellent physical health after passage of the law, compared 23 percent before.

How insurance may have contributed to the apparent health improvements remains unclear. The researchers did not detect any meaningful increase in the use of health care services among young adults after 2010. Their use of primary care remained constant, while it declined among the older group in 2011.

Chua speculated that the additional protections from having health coverage may contribute to a greater sense of security and health, a phenomenon that other research on coverage expansions has detected.

Tracking the young adult population over more years after they gained coverage may further explain the health effects of insurance.

Photo: LeDawna’s Pics via Flickr

Many Democrats are getting nervous about the upcoming presidential election. Ominous, extensively reported articles by two of the best in the business—the New Yorker's Jeffrey Toobin and The Atlantic's Barton Gellman—outline Boss Trump's plot to keep control of the White House in 2021 no matter how the American people vote.
Trump is hardly making a secret of it. He's pointedly refused to commit to "a peaceful transfer of power."

"Well, we're going to have to see what happens," is how he answered the question. He added that after we "get rid of the ballots"—presumably mail-in ballots he's been whining about for weeks--"there won't be a transfer, frankly. There'll be a continuation."

Of course, Trump himself has always voted by mail, but then brazen hypocrisy is his standard operating mode. If you haven't noticed, he also lies a lot. Without prevaricating, boasting, and bitching, he'd be mute. And even then, he'd still have Twitter. He recently tweeted that the winner "may NEVER BE ACCURATELY DETERMINED" because mail-in ballots make it a "RIGGED ELECTION in waiting."
Gellman gets this part exactly right in The Atlantic: "Let us not hedge about one thing. Donald Trump may win or lose, but he will never concede. Not under any circumstance. Not during the Interregnum and not afterward. If compelled in the end to vacate his office, Trump will insist from exile, as long as he draws breath, that the contest was rigged.
"Trump's invincible commitment to this stance will be the most important fact about the coming Interregnum. It will deform the proceedings from beginning to end. We have not experienced anything like it before."
No, we haven't. However, it's important to remember that Trump makes threats and promises almost daily that never happen. Remember that gigantic border wall Mexico was going to pay for? Trump has built exactly five miles of the fool thing, leaving roughly two thousand to go.
His brilliant cheaper, better health care plan? Non-existent.
On Labor Day, Boss Trump boasted of his unparalleled success in strong-arming Japan into building new auto-manufacturing plants. "They're being built in Ohio, they're being built in South Carolina, North Carolina, they're being built all over and expanded at a level that we've never seen before."
Not a word of that is true. Two new plants, one German, another Swedish have opened in South Carolina, but construction began before Trump took office. Auto industry investment during Barack Obama's second term far exceeded Trump's. His version is sheer make-believe.
But back to the GOP scheme to steal the election.
First, it's clear that even Trump understands that he has virtually no chance of winning the national popular vote. He's been polling in the low 40s, with no sign of change. To have any chance of prevailing in the Electoral College, he's got to do the electoral equivalent of drawing to an inside straight all over again—winning a half-dozen so-called battleground states where he defeated Hillary Clinton in 2016 by the narrowest of margins.
At this writing, that looks highly unlikely. The latest polling in must-win Pennsylvania, for example, shows Trump trailing Joe Biden by nine points. That's a landslide. Trump's down ten in Wisconsin, eight in Michigan. And so on.
So spare me the screeching emails in ALL CAPS, OK? Polls were actually quite accurate in 2016. Trump narrowly defeated the odds. It can happen. But he's in far worse shape this time. Furthermore, early voting turnout is very high, with Democrats outnumbering Republicans two to one.
Hence, The Atlantic reports, "Trump's state and national legal teams are already laying the groundwork for post-election maneuvers that would circumvent the results of the vote count in battleground states."
The plan is clear. Because more Democrats than Republicans are choosing mail-in voting during the COVID pandemic, Trump hopes to prevent those ballots from being counted. Assuming he'll have a narrow "swing state" lead on election night, he'll declare victory and start filing lawsuits. "The red mirage," some Democrats call it.
"As a result," Toobin writes, "the aftermath of the 2020 election has the potential to make 2000 look like a mere skirmish." With Trump in the White House urging armed militias to take to the street.
Mail-in votes take a long time to count. Things could definitely get crazy.
True, but filing a lawsuit to halt a Florida recount was one thing. Filing suits against a half dozen states to prevent votes from being counted at all is quite another. Public reaction would be strong. Also, winning such lawsuits requires serious evidence of fraud. Trumpian bluster ain't evidence.
The Atlantic reports that GOP-controlled state legislatures are thinking about sending Trumpist delegations to the Electoral College regardless of the popular vote winner—theoretically constitutional but currently illegal.
Fat chance. If that's the best they've got, they've got nothing.
Anyway, here's the answer: Vote early, and in person*.

[Editor's note: In some states, receiving an absentee ballot means that a voter can no longer vote in person* or may have to surrender the absentee ballot, including the envelope in which it arrived, at their polling place. Please check with your local election authorities.]