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Two research studies published this month add important data to the 

 over Medicaid in Washington, D.C.Each study — one published last week in the “

 from the nonpartisan National Bureau of Economic Research — offers evidence that Medicaid, the public insurance program that covers more than 70 million low-income and disabled Americans, is saving people's lives. 

, these findings underscore the importance of treading carefully, said Harvard University economist Amitabh Chandra, who was not involved in either study.

"What we're learning is that restricting access to Medicaid might save us money, but that comes at a tremendous cost," said Chandra. "And that cost is human lives."

 paper, by Angela Wyse, an economist at Dartmouth College, and Bruce Meyer, a University of Chicago economist, focused on the millions of low-income adults who gained Medicaid coverage in states that expanded the program under the Affordable Care Act. After examining a dataset of 37 million people, the authors found:

The study does not explain how Medicaid expansion had this effect, but prior research has shown the program is linked with 

reductions in deaths from diseases like diabetes and cancer

Wyse and Meyer also found that younger adults, who many have long assumed have less to gain from insurance, saw strong life-saving effects from the program, too. The authors suggest that coverage of mental health and substance use treatment for this age group could be key.

Medicaid brings life-saving drugs within reach

 study, published May 14, examined Medicaid's effects on a smaller, yet 

 of people who are eligible for both Medicare and Medicaid.

These 12 million Americans have low incomes and are also either disabled or over age 65, with some checking all three boxes. To get the care they need, this group of "duals," as they're often called by policymakers, are forced to navigate both of the country's largest public health insurance programs.

When duals lose their Medicaid they also lose 

vital Medicare coverage that lowers prescription drug costs

 (the Part D Low-Income Subsidy) by roughly $6,000 a year on average. However, due to a quirk in policy, some people are able to keep this subsidy longer than others, depending on when in the year they lose their Medicaid.

The study's authors, led by University of Pennsylvania economist Eric Roberts and Harvard researcher José Figueroa, took advantage of this disenrollment quirk to isolate and measure the Part D Low-Income Subsidy's effects. They found that compared to patients who kept this extra help for longer, those who lost it sooner:

Chandra, the Harvard economist, said that in addition to showing the value of Medicaid, this "remarkable paper" helps answer a much larger question.

"It's great that we now know Medicaid saves lives, but there's still been this question about why," said Chandra. "Why does Medicaid cause people to live longer?"

One clear reason, at least according to this paper, he said, is that the program makes prescription drugs easier to get. And that, said Chandra, is a testament to the value of not only Medicaid, but also medication access more broadly.

A regulation from the Department of Health and Human Services 

 was poised to help nearly 1 million more duals gain this extra medication assistance. But 

the study's coauthor, highlighted one other timely implication of his team's results.

, Republicans are proposing increased frequency of eligibility checks as well as requiring states to 

 — both of these could make it harder for people to stay on Medicaid.

Research shows it's common for people to 

 (as their income fluctuates, for example, or because of paperwork errors) but regain it soon thereafter — a phenomenon known as "churn."

Policies that increase churn could have deadly effects, according to Roberts.

"For very sick, very poor people, even going one week without life-saving drugs can have huge consequences," he said.

Roberts found that nearly 3,000 duals died despite many of those people only losing their drug subsidy for about two extra months.

Together, the two research papers highlight a tough reality for congressional Republicans as they continue to consider a slate of possible Medicaid cuts to fund their other policy priorities.

No matter how they shrink the program, whether by making federal funding less generous or paperwork more onerous, this new evidence suggests that some people are likely to get hurt.

This story comes from the nonprofit health news organization 

 on its website. Leslie Walker is a senior reporter/producer for Tradeoffs.

Leslie Walker

Author

Researchers studied the health care program's effect on the health of millions of Americans and found tens of thousands of lives were saved.

New studies show what's at stake if Medicaid is scaled back

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