It turns out that the expansion of Medicaid coverage under the Affordable Care Act has proven very beneficial to states that adopted it.1 It’s probably not surprising that access to care has improved—especially for low-income and vulnerable populations—which has resulted in better health outcomes. For example, early-stage cancer diagnosis rates have gone up as have certain types of cancer surgery. Treatments (including medication-assisted treatment) for opioid use disorder and opioid overdose are now covered; and there is improved parity for behavioral health care.
States and providers have seen economic benefits as well. In the early years of the Affordable Care Act, the federal government covered 100% of the cost of the expansion, which resulted in state savings—states were able to offset costs in areas such as behavioral health services and the criminal justice system. Consequently, these states are seeing better economic outcomes with lower rates of unemployment and a reduction in poverty.
What probably wasn’t expected from the expanded coverage, was the beneficial impact on crime. He and Barkowski2 estimate that the expansion reduced the incidence of burglary, vehicle theft, homicide, robbery, and assault. They point out that, “These crime-reduction spillover effects represent an important offset to the government’s cost burden for the ACA Medicaid expansion.”
1. Antonisse L, Garfield R, Rudowitz R, Guth M. The Effects of Medicaid Expansion Under the ACA: Updated Findings From a Literature Review. Kaiser Family Foundation. August 2019.
2. He Q, Barkowski S. The effect of health insurance on crime: evidence from that Affordable Care Act Medicaide Expansion. Health Econ. 2020;29:261-277.