A new study finds that Romneycare – the Massachusetts health insurance program that was used as a model for the Affordable Care Act – has prevented 230 deaths a year since it began in 2006. Since this study collected data on 270,000 people for a full four years – not just the initial months after people were covered – this is the best evidence yet that health insurance and access to care saves lives.
What does that mean for Maine, the last New England state still refusing to expand Medicaid to cover the uninsured?
It likely means that Mainers will continue to have the shortest life expectancies in New England. It probably means that chronic disease rates and preventable deaths will continue to be highest in our poorest, rural counties. And these counties are where Medicaid expansion could make the biggest difference – the Massachusetts study also notes that death rates decreased most in counties with the highest rates of uninsured and the lowest household incomes. The study also found secondary gains in better self-reported health. Simply put: when researchers asked, people said that their health was better.
These findings mean a lot for our state’s productivity. In the Maine counties with the highest rates of people without health insurance, almost 20% of residents report that their health is poor or fair. A high percentage of unhealthy workers comes with economic costs. It means that people will be unable to work because of disabling conditions. Untreated chronic conditions such as diabetes or lower respiratory disease add up to higher rates of disability, and Maine has one of the highest rates of disability in the nation. As a rural state with many jobs in logging, farming and fishing, Maine also has one of the highest rates of work-related injury in the nation. Uninsured people are less likely to survive trauma – potentially due to skipped diagnostic tests or treatments.
Leaving people uninsured also means that people will miss more work due to poor health – either their own, or that of a family member who requires care. A national report estimated that lost productivity due to chronic illness amounted to $260 billion – 2.4% of GDP.
Promoting a vital Maine economy- with jobs that pay a living wage and afford opportunity for advancement -is not as easy as cutting taxes or attacking the less fortunate who seek government aid to get back on their feet. High-wage, high-value-added businesses do not make locational decisions based on tax breaks. The factors that such business owners look for are tied to quality of place: good roads, good schools, and a well-educated, healthy workforce prepared for managerial or technical professions. Maine’s policymakers need to focus on these workforce strategies – rather than working to keep 70,000 Mainers uninsured. And because it will support as many as 4,400 jobs and add half billion dollars to Maine’s economy, accepting federal funds to expand MaineCare is a great place to start.
Mainers are taking advantage of the Affordable Care Act. More than 44,000 residents signed up for health insurance through the ACA Marketplace, beating enrollment targets. For the first time in history, almost all Americans have access to affordable insurance – except for the poorest people in states like Maine that have so far refused to accept federal funds to expand Medicaid. Poor Mainers, working at low-wage jobs that rarely offer benefits, have been left out of health reform. Policymakers should understand that choosing to leave 70,000 Mainers uninsured comes at a high economic cost.