The Long-Term Effect of Health Insurance on Near-Elderly Health and Mortality | Cato Institute

September 3, 2017

Featuring Bernard S. Black, Nicholas J. Chabraja Professor, Northwestern University, Pritzker School of Law; Megan McArdle, Columnist, Bloomberg View; Benjamin Sommers, Associate Professor of Health Policy and Economics, Harvard H.T. Chan School of Public Health; moderated by Michael F. Cannon, Director of Health Policy Studies, Cato Institute.

A key question in debates over whether states should implement Obamacare’s Medicaid expansion, and whether Congress should repeal Obamacare entirely, is whether government expansions of health insurance coverage improve health, and if so, how much. A new study by Bernard Black and colleagues finds that the uninsured “consume fewer healthcare services, but their health (while alive) does not deteriorate relative to the insured, and, in our central estimates, they do not die significantly faster than the insured.” Come hear Professor Black and leading scholars discuss one of the most important but least understood aspects of health reform.

If you can’t make it to the event, you can watch it live online at and join the conversation on Twitter using #CatoEvents. Follow @CatoEvents on Twitter to get future event updates, live streams, and videos from the Cato Institute.

Source: The Long-Term Effect of Health Insurance on Near-Elderly Health and Mortality | Cato Institute


Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health

June 28, 2017

The goal of the Affordable Care Act (ACA) was to achieve nearly universal health insurance coverage through a combination of mandates, subsidies, marketplaces, and Medicaid expansions, most of which took effect in 2014. We use data from the Behavioral Risk Factor Surveillance System to examine the impacts of the ACA on health care access, risky health behaviors, and self-assessed health after two years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from state participation in the Medicaid expansion and pre-ACA uninsured rates. Results suggest that the ACA led to sizeable improvements in access to health care in both Medicaid expansion and non-expansion states, with the gains being larger in expansion states along some dimensions. No statistically significant effects on risky behaviors or self-assessed health emerge for the full sample. However, we find some evidence that the ACA improved self-assessed health among older non-elderly adults, particularly in expansion states.

Source: Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health

Affordable Care Act Changes To Medicare Led To Increased Diagnoses Of Early-Stage Colorectal Cancer Among Seniors

February 1, 2017

The Affordable Care Act (ACA) helped make preventive care, including recommended cancer screening, more affordable and accessible for millions of Americans. Using population-based data from the Surveillance, Epidemiology, and End Results (SEER) Program, we estimated the impact of ACA policy changes to facilitate the diagnosis of cancer at an earlier and more treatable stage. We estimated that the ACA resulted in an increase of 8,400 (8 percent) diagnoses of early-stage colorectal cancer among US seniors in the period 2011–13. However, the ACA had no distinguishable effect on the number of diagnoses of early-stage breast cancer over the same time period. It is likely that the ACA initially affected the diagnosis of colorectal cancer more than that of breast cancer because the decrease in out-of-pocket spending was larger for colorectal than for breast cancer screening.

Source: Affordable Care Act Changes To Medicare Led To Increased Diagnoses Of Early-Stage Colorectal Cancer Among Seniors

“Lifecycle Benefits of an Influential Early Childhood Program” One-Pager | Heckman

December 13, 2016

Start at birth, coordinate services into comprehensive early childhood programs and achieve greater economic and social gains. Professor Heckman’s latest research, “The Lifecycle Benefits of an Influential Early Childhood Program,” shows that high quality birth-to-five programs for disadvantaged children can deliver a 13% per year return on investment—a rate substantially higher than the 7-10% return previously established for preschool programs serving 3- to 4-year-olds. Heckman, his University of Chicago colleague Jorge Luis García, Duncan Ermini Leaf of the Leonard D. Schaeffer Center for Health Policy and Economics at University of Southern California, and María José Prados of the Dornsife Center for Economic and Social Research at University of Southern California, find that significant gains are realized through better outcomes in education, health, social behaviors and employment.

Source: “Lifecycle Benefits of an Influential Early Childhood Program” One-Pager | Heckman

New Evidence: Obamacare Is Not Saving Lives

December 12, 2016

Now, new data from the Centers for Disease Control and Prevention shows that a U.S. life expectancy dropped in 2015 – a year after the major provisions of the ACA went into effect – and for the first time since 1993, when according to NPR, the drop was attributed to the AIDS epidemic, a flu outbreak, and an spike in homicide rates. While the relationship between health insurance and mortality might still be debated – and it is certainly too early to suggest, as NPR’s analysis implies, that the ACA is as bad as the AIDS epidemic – one thing is clear: There is no evidence that the ACA is, on net, saving lives.

Source: New Evidence: Obamacare Is Not Saving Lives

U.S. Life Expectancy Declines, and Researchers Are Puzzled – The New York Times

December 8, 2016

A study on mortality rates released on Thursday by the National Center for Health Statistics showed that Americans could expect to live for 78.8 years in 2015, a decrease of 0.1 from the year before. The overall death rate increased 1.2 percent — that’s about 86,212 more deaths than those recorded in 2014.

Dr. Peter Muennig, a professor of health policy and management at Columbia University’s Mailman School of Public Health, said in an interview that the decline was a “uniquely American phenomenon” in comparison with other developed countries, like Japan or Sweden.“A 0.1 decrease is huge,” Dr. Muennig said. “Life expectancy increases, and that’s very consistent and predictable, so to see it decrease, that’s very alarming.”

What’s causing the decline? For researchers, the numbers reflect a culmination of problems: eight of the top 10 causes of death showed an increase in death rates, including those from heart disease, diabetes and kidney disease. Deaths from Alzheimer’s rose 15.7 percent, unintentional injuries rose 6.7 percent and suicide rose 2.3 percent.The infant mortality rate, often the marker researchers use to gauge the health of a population, rose slightly, but Dr. Jiaquan Xu, one of the authors of the study, said that the rise was not considered significant.Dr. Muennig said that popular theories for the cause of the decline, including an increase in obesity rates and an opiod epidemic, fail to explain a problem that feels broader.“If you actually dissect the data neither of those arguments hold,” he said. “This report slams it home that this is really a mystery.”Is there any positive news?Dr. Xu said that the study’s lone bright spot showed a decline in deaths from cancer, by 1.7 percent.“That’s the only part that’s good news,” he said.How does race play a factor in my life span?The study is further confirmation of a decline in health in different racial populations. Death rates among non-Hispanic black males rose 0.9, and 1 percent among non-Hispanic white males. Rates for non-Hispanic white females rose 1.6 percent.Rates for non-Hispanic black females, Hispanic males, and Hispanic females held steady from 2014 to 2015.Dr. Muennig said that a decline in the health of working class whites was a major contributor to the latest survey results. Life expectancy for whites has stagnated or dipped in recent years, fueled by vulnerability to drug and alcohol abuse, suicide and economic distress.“It’s not happening to black people,” Dr. Muennig said. “That group used to have a huge and growing disparity with whites, but that gap has radically narrowed.”AdvertisementContinue reading the main storyIn 2014, the life expectancy gap between black and white people closed to 3.4 years, the smallest on record.What about income?Thursday’s survey did not break people down by income or education level, but past research has shown that as the gap between the rich and poor in America widens, people of different income levels can expect to live for different lengths of time.In February, researchers at the Brookings Institution analyzed life expectancies for men who were among the top 10 percent of earners, and those who were among the bottom 10 percent. For men born in 1950, life expectancy was 14 years shorter than for those among the rich.Dr. Muennig said that researchers suspect that the strain of income inequality in the United States — and the stress that this causes — could be a major contributing factor to the uptick, but it has been hard to prove beyond one thread of research that studies how earned-income tax credits can help improve the health of people with low incomes.Does sex play a factor?Yes. According to the data, life expectancy for females remains consistently higher than it for males. In 2015, the difference in life expectancy between females and males increased to 4.9 years in 2015, up from 4.8 years in 2014.What do these numbers mean for the future?Dr. Xu said in an interview that the decline doesn’t necessarily show a trend, but that the numbers are cause for concern.“If a year from now if this situation continues,” Dr. Xu said, “it’s definitely a problem for public health.”Continue reading the main storyRELATED COVERAGEOpinion David LeonhardtThe American Dream, Quantified at Last DEC. 8, 2016White Americans Are Dying Younger as Drug and Alcohol Abuse Rises APRIL 20, 2016Black Americans See Gains in Life Expectancy MAY 8, 2016TRENDINGJohn Glenn, American Hero of the Space Age, Dies at 95‘They Are Slaughtering Us Like Animals’Trump’s Labor Pick, Andrew Puzder, Is Critic of Minimum Wage IncreasesOn Campus, Trump Fans Say They Need ‘Safe Spaces’Contributing Op-Ed Writer: Trump Voters Are Feeling ItSouth Korea’s President Awaits Her Fate, Dejected, Sleepless and AloneOp-Ed Columnist: Trump: Madman of the YearThe Best Movies of 2016Trilobites: That Thing With Feathers Trapped in Amber? It Was a Dinosaur TailOp-Ed Columnist: The American Dream, Quantified at LastView More Trending Stories »What’s NextLoadi

Hundreds on Medicaid waiting list in Illinois die while waiting for care | Illinois Policy | Illinois’ comeback story starts here

November 25, 2016

The state’s most recent enrollment reports show more than 650,000 able-bodied adults have enrolled in Medicaid since the Obamacare expansion, and this enrollment shows no sign of slowing down. This is nearly twice as many adults as the state said would ever enroll and more than the state said would ever even be eligible.

Expansion costs are also significantly over projections. Despite promises from the administration of former Gov. Pat Quinn that total expansion costs would “only” hit $2.7 billion in the first two years, costs actually came in at $4.7 billion – 70 percent higher than promised.

Source: Hundreds on Medicaid waiting list in Illinois die while waiting for care | Illinois Policy | Illinois’ comeback story starts here