Bottom Line: Expanding Medicaid eligibility was associated with lower rates of death from cardiovascular causes in a study comparing data from counties in 29 states that expanded Medicaid with 19 states that didn't from 2010 to 2016. Cardiovascular mortality among adults ages 45 to 64 was stable in counties in expansion states between the preexpansion and postexpansion periods (146.5 to 146.4 deaths per 100,000 residents per year). In counties in nonexpansion states, there was an increase in cardiovascular mortality rates during the preexpansion and postexpansion periods (176.3 to 180.9 deaths per 100,000 residents per year). Counties in expansion states had 4.3 fewer deaths from cardiovascular causes per 100,000 residents per year after accounting for differences in demographic, clinical, economic and health access factors. This is an observational study so causal inferences can't be drawn between the expansion of Medicaid eligibility and differences in cardiovascular mortality rates. Policymakers may want to consider these results as they debate more changes to Medicaid eligibility and expansion.
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Authors: Sameed Ahmed M. Khatana, M.D., University of Pennsylvania, Philadelphia, and coauthors
(doi:10.1001/jamacardio.2019.1651)
Editor's Note: The article contains conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
JAMA Cardiology