The Affordable Care Act is, with a few lagging details, now in full effect around the country. The first open enrollment season came to an end in March, and the administration was able to boast reaching their target of 7 million signups. It is still too early to know the long-term effects of the health-care law, but the numbers are already suggesting a steady decline in the numbers of uninsured individuals, particularly in states that made the decision to embrace the law and who made an effort to make exchanges easily available to their citizens.
But when it comes to the long-term effects of the ACA, we can look to Massachusetts, whose health care law went into effect in 2006. The national ACA is based is many ways on the Massachusetts law, including the individual mandate. A study released on Monday claims that the mortality rate in Massachusetts declined rather rapidly in the period from 2007, just after the law went into effect, to 2010. According to the study, the decline in mortality was steepest in counties with the highest proportions of poor and previously uninsured people.
Overall, the study shows that in the four years after the law went into effect, the mortality rate dropped about 3 percent. Of course, the exact reasons for the decline are not entirely known, but one possible explanation given is simply that when people have health insurance, they are less likely to put off treatment. People with chronic illness, such as diabetes, can afford to get regular medication, which lessens the likelihood that they will end up in the emergency room in renal failure. People who have treatable illnesses are seeking treatment earlier in the process – before they become emergencies. All of this results in people actually living longer lives.
Of course, Massachusetts is not a perfect sample for the rest of the nation. Not all states, for example, decided to expand Medicaid, which would help the communities most likely to be left uninsured. Furthermore, the population of Massachusetts tends to be more white and more affluent than the rest of the country. But if the United States experienced a 3 percent decline in mortality, that would be somewhere around 17,000 people living instead of dying per year. Imagine then, how many people might avoid bankruptcy following a medical emergency, or make other life-altering decisions based solely on whether or not they can afford medical treatment.
Around the United States, people are still suspicious of the Affordable Care Act, and certainly the Supreme Court is still facing challenges to various provisions within the law. The USCCB has ranged in its attitude toward the ACA from disinterested to downright hostile. However, the evidence that we have shows that access to affordable health insurance does in fact extend the lives of individuals. It also makes them less likely to have to make a decision between medical care and housing, for example. Assuring that people have access to affordable health insurance not only serves to prolong life; it serves to preserve the dignity of and value of each person, especially those who live out their lives on the margins.
Image: By M.O. Stevens (Own work) CC-BY-3.0 via Wikimedia Commons
