A 2019 review by Kaiser Family Foundation of 324 studies on<unk>  expansion concluded that "expansion is linked to gains in coverage; improvements in access, financial security, and some measures of health status/outcomes; and economic benefits for states and providers." A 2021 study found that<unk>  expansion as part of the Affordable Care Act led to a substantial reduction in mortality, primarily driven by reductions in disease-related deaths. A 2018 study in the Journal of Political Economy found that upon its introduction,<unk>  reduced infant and child mortality in the 1960s and 1970s. The decline in the mortality rate for nonwhite children was particularly steep. A 2018 study in the American Journal of Public Health found that the infant mortality rate declined in states that had<unk>  expansions (as part of the Affordable Care Act) whereas the rate rose in states that declined<unk>  expansion. A 2020 JAMA study found that<unk>  expansion under the ACA was associated with reduced incidence of advanced-stage breast cancer, indicating that<unk>  accessibility led to early detection of breast cancer and higher survival rates. A 2020 study found no evidence that<unk>  expansion adversely affected the quality of health care given to Medicare recipients. A 2018 study found that<unk>  expansions in New York, Arizona, and Maine in the early 2000s caused a 6% decline in the mortality rate: "HIV-related mortality (affected by the recent introduction of antiretrovirals) accounted for 20% of the effect. Mortality changes were closely linked to county-level coverage gains, with one life saved annually for every 239 to 316 adults gaining insurance. The results imply a cost per life saved ranging from $327,000 to $867,000 which compares favorably with most estimates of the value of a statistical life." A 2016 paper found that<unk>  has substantial positive long-term effects on the health of recipients: "Early childhood<unk>  eligibility reduces mortality and disability and, for whites, increases extensive margin labor supply, and reduces receipt of disability transfer programs and public health insurance up to 50 years later. Total income does not change because earnings replace disability benefits." The government recoups its investment in<unk>  through savings on benefit payments later in life and greater payment of taxes because recipients of<unk>  are healthier: "The government earns a discounted annual return of between 2% and 7% on the original cost of childhood coverage for these cohorts, most of which comes from lower cash transfer payments". A 2019 National Bureau of Economic Research paper found that when Hawaii stopped allowing Compact of Free Association (COFA) migrants to be covered by the state's<unk>  program that<unk> -funded hospitalizations declined by 69% and emergency room visits declined by 42% for this population, but that uninsured ER visits increased and that<unk> -funded ER visits by infants substantially increased. Another NBER paper found that<unk>  expansion reduced mortality. A 2020 study found that<unk>  expansion boosted the revenue and operating margins of rural hospitals, had no impact on small urban hospitals, and led to declines in revenue for large urban hospitals. A 2021 study found that expansions of adult<unk>  dental coverage increasingly led dentists to locate to poor, previously underserved areas. A 2019 paper by Stanford University and Wharton School of Business economists found that<unk>  expansion "produced a substantial increase in hospital revenue and profitability, with larger gains for government hospitals. On the benefits side, we do not detect significant improvements in patient health, although the expansion led to substantially greater hospital and emergency room use, and a reallocation of care from public to private and better-quality hospitals." A 2017 survey of the academic research on<unk>  found it improved recipients' health and financial security. Studies have linked<unk>  expansion with increases in employment levels and student status among enrollees. A 2017 paper found that<unk>  expansion under the Affordable Care Act "reduced unpaid medical bills sent to collection by $3.4 billion in its first two years, prevented new delinquencies, and improved credit scores. Using data on credit offers and pricing, we document that improvements in households' financial health led to better terms for available credit valued at $520 million per year. We calculate that the financial benefits of<unk>  double when considering these indirect benefits in addition to the direct reduction in out-of-pocket expenditures." Studies have found that<unk>  expansion reduced rates of poverty and severe food insecurity in certain states. Studies on the implementation of work requirements for<unk>  in Arkansas found that it led to an increase in uninsured individuals, medical debt, and delays in seeking care and taking medications, without any significant impact on employment. A 2021 study in the American Journal of Public Health found that<unk>  expansion in Louisiana led to reductions in medical debt. A 2021 American Economic Review study found that early childhood access to<unk>  "reduces mortality and disability, increases employment, and reduces receipt of disability transfer programs up to 50 years later.<unk>  has saved the government more than its original cost and saved more than 10 million quality adjusted life years." A 2017 study found that<unk>  enrollment increases political participation (measured in terms of voter registration and turnout). Studies have found that<unk>  expansion reduced crime. The proposed mechanisms for the reduction were that<unk>  increased the economic security of individuals and provided greater access to treatment for substance abuse or behavioral disorders. Oregon<unk>  health experiment and controversy In 2008, Oregon decided to hold a randomized lottery for the provision of<unk>  insurance in which 10,000 lower-income people eligible for<unk>  were chosen by a randomized system. The lottery enabled studies to accurately measure the impact of health insurance on an individual's health and eliminate potential selection bias in the population enrolling in<unk> . A sequence of two high-profile studies by a team from the Massachusetts Institute of Technology and the Harvard School of Public Health found that<unk>  coverage generated no significant improvements in measured physical health outcomes in the first 2 years", but did "increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain." The study found that in the first year: # Hospital use increased by 30% for those with insurance, with the length of hospital stays increasing by 30% and the number of procedures increasing by 45% for the population with insurance; #<unk>  recipients proved more likely to seek preventive care. Women were 60% more likely to have mammograms and recipients overall were 20% more likely to have their cholesterol checked; # In terms of self-reported health outcomes, having insurance was associated with an increased probability of reporting one's health as "good", "very good", or "excellent"—overall, about 25% higher than the average; # Those with insurance were about 10% less likely to report a diagnosis of depression. #Patients with catastrophic health spending (with costs that were greater than 30% of income) dropped.<unk>  patients had cut in half the probability of requiring loans or forgoing other bills to pay for medical costs. The studies spurred a debate between proponents of expanding<unk>  coverage and fiscal conservatives challenging the value of this expansive government program.
Medicaid
Pharmacare
Creosote
Pharmasave
BioSense
Accident
Biovail
Medicare 