Obamacare is a big, messy law with so many moving parts, it is often hard to tell how well it’s working. People debate whether it is killing jobs or creating them; they argue about whether it is lowering medical expenses or raising them. These debates often feel irresolvable because the law, being a national one, doesn’t allow for easy analysis. When an entire health care system changes in all 50 states simultaneously, it’s difficult to know what the world would have looked like if the law hadn’t existed.
That’s one reason the Obamacare Medicaid expansion is so interesting. You see, 19 states have refused to expand their Medicaid programs, leaving us with a kind of experiment – we can compare what happened in those 19 states with what happened in the other 31. That’s what Laura Wherry and Sarah Miller did in a study published in the Annals of Internal Medicine. In fact, that’s how we know that Obamacare causes diabetes.
Let me explain.
Wherry and Miller used data from the National Health Interview Study, looking at responses from people with incomes less than 138% of the federal poverty limit. In states that expanded Medicaid, all such people now qualify for healthcare coverage. But in states that didn’t expand, Medicaid eligibility is typically more stringent, as low as 75% of the federal poverty limit in some states. Wherry and Miller looked at data from before and after Obamacare expansions went into effect, to see how things changed in expansion versus non-expansion states.
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