Better preventative care is perhaps one of the greatest gifts of Obamacare. Thanks to the expansion of Medicaid, many lower-income people have gotten access to affordable primary health care; this in turn has led to better illness prevention. The result is not just healthier people, but money saved through less time spent sick.
A new study from researchers at Indiana and Cornell Universities looked at the effects of the Affordable Care Act’s (ACA) Medicaid expansion on a specific group: low-income, non-elderly, non-disabled childless adults–folks who wouldn’t normally be eligible for coverage without the ACA. This group is now 17% more likely to have health insurance, 7% more likely to have a personal doctor, and 11% “less likely to report that cost was a barrier to their health care,” according to a statement from the Indiana University Newsroom.
For many people, preventative medicine might be the most life-changing part of the ACA. Instead of only visiting doctors after things have gone wrong–often long after they have gone wrong–people can get regular checkups or visit doctors for guidance. This helps doctors catch problems early, and also gives the patient access to medical advice so they can prevent trouble before it starts. Regular dental visits are one example, as are HIV tests and flu vaccinations. In another study, cancer detection in seniors increased for exactly the same reasons.
To determine the effects of the ACA on preventative medicine, the researchers exploited a glitch in the legislation. The ACA originally required Medicaid to be extended to all adults whose income was below 138% of the federal poverty line, according to the study. But a 2012 ruling by the Supreme Court allowed states to opt out, leaving only 31 states and Washington, D.C., with expanded care. This allowed the researchers to set up a comparison between the two groups of states.
The results are clear. More people with more access to early care means fewer sick people, and fewer days wasted due to illness. The study also looked at one other aspect: the fear that lower medical expenses would lead people to to spend their money on alcohol and drugs instead. “The newly insured may allocate some of the funds they would have otherwise devoted to health care toward risky health behaviors (e.g., cigarettes or eating more) or toward health improvements,” the study authors wrote.
But poor people, the researchers found, didn’t rush out and spend those few extra dollars on getting high or poisoning themselves with fast food, despite the patronizing expectation that they would do so. However, alcohol, drugs, and a bad diet are serious health concerns in the U.S.; and the study showed that Medicaid improvements didn’t reduce these problems, either.
Despite that, it’s hard to argue with the study’s overarching finding: Give people cheap access to good healthcare and they won’t get sick as often. It seems obvious, which makes you wonder about the motivation of the states which voted not to provide it to their citizens–and Donald Trump’s larger effort to roll back the ACA entirely.