Analysis indicates that insurance expansion improves access to care, health, and survival
By a
The review--the most current analysis of its kind--will be published online
As the national debate continues over the future of the Affordable Care Act (ACA), which has expanded health insurance to more than 20 million Americans, there has been intense debate about what effects, if any, insurance coverage has on health and mortality. The researchers sought to address that question.
"We know far more now about the effects of health insurance than we did when the ACA was originally passed, due to many recent high-quality studies. The evidence we reviewed in this paper shows that coverage makes a major difference in people's ability to live healthier and longer lives," said
The Harvard Chan researchers synthesized the most rigorous evidence from the past decade, drawing on findings from more than 40 papers, including major studies of their own. The body of evidence showed that coverage expansions have produced significantly higher rates of being able to afford needed care, and having access to preventive services, primary care, chronic illness treatment, medications, and surgical care. In turn, these changes have led to a wide range of improvements in health. For example:
The authors acknowledged that findings from many of the studies they reviewed are nuanced, and some are seemingly contradictory. The differences are due, at least in part, to major differences in study design or length or to the complexity of the links between insurance coverage and particular health effects. But across the multitude of studies, the authors found compelling evidence that health insurance leads to important but often gradual improvements in health and survival. People with health insurance are also more financially secure, with lower out-of-pocket spending and fewer medical debts. These gains must be weighed against the cost of financing public subsidies for insurance.
The authors conclude: "There remain many unanswered questions about
Keywords for this news article include: Legislation, Health Policy,
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