Study links Medicaid expansion with lower cardiovascular disease mortality rates

States that expanded Medicaid saw lower mortality rates from cardiovascular disease compared to nonexpansion states, according to a new study. 

Researchers led by a team at the University of Pennsylvania found that counties in expansion states saw 4.3 fewer deaths from cardiovascular conditions per 100,000 after Medicaid was expanded. 

That translates to about 2,000 fewer deaths per year among middle-income adults in each expansion state, the study found. 

Sameed Khatana, M.D., a fellow in cardiovascular disease at the Hospital of the University of Pennsylvania and the study’s lead author, told FierceHealthcare that there is a growing body of research that examines the clinical outcomes related to Medicaid expansion.  

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These are crucial data, he said, as legislators consider various changes to their Medicaid programs or are planning to expand the program. 

“There are very important political debates surrounding these issues, a lot of individuals and pats care about it,” Khatana said. The study team was “freely examining to see what the impacts were, and I think that’s important as policymakers are debating making further changes to Medicaid.” 

Khatana said there are likely multiple factors that led to the decrease in mortality rates, but a central one is that under Medicaid expansion more people were covered—ensuring that they sought care sooner, which boosted their survival chances. 

The study found that the counties where the most people gained coverage under the Affordable Care Act saw the greatest declines in cardiovascular disease mortality. 

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Khatana said previous research indicates that uninsured patients are more likely to delay or skip care, even in high-risk situations like a heart attack. And a long wait can significantly increase the risk of major complications or death, he said. 

“When it comes to heart attacks, we say time is myocardium,” Khatana said. 

The study also noted that there were spillover effects into the Medicare-aged population in these areas, which indicates that other potential impacts of expansion could be linked to stronger financial performance of community and safety-net hospitals. 

In addition, previous research has found that when things improve for people who are or were recently uninsured, that also benefits the insured population, the researchers said.