Las Vegas Sun

October 17, 2021

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Sun editorial:

Results are in: Decision to expand Medicaid has been fruitful for state

Nevada was an early adopter of Medicaid expansion in 2014, and since then has fought against Republican-led efforts to weaken the program.

Now, new studies are starting to quantify the gains we’ve achieved through our efforts. And those gains are impressive.

JAMA Cardiology, published by the American Medical Association, reported last month on a study in which researchers showed that Medicaid expansion reduced deaths from cardiovascular causes by an average of 4.3 people per 100,000. In arriving at that figure, the researchers showed that mortality rates increased among residents in states that hadn’t adopted Medicaid expansion, while the rates in Nevada and other expansion states stayed flat.

Think about that. With our state population of about 3 million, that’s nearly 130 Nevadans per year whose lives were saved thanks to newly acquired Medicaid access. And considering that Nevada adopted expansion in 2014, the five-year total of lives saved is at 650 and counting.

Meanwhile, another new study shows that Medicaid expansion is improving health outcomes by reducing racial disparities in cancer treatment. In that study, which was presented at the American Society of Clinical Oncology’s annual meeting, researchers looked at the cases of 34,067 patients who were diagnosed with cancer from January 2011 through December 2018 to determine whether those individuals had received “timely treatment” — or treatment within a month of diagnosis.

The study showed that before Medicaid expansion went into place, black patients were 4.9 percentage points less likely to have undergone timely treatment than their white counterparts. But after states expanded the program, that disparity vanished.

These are only two examples of the benefits of expansion, and many more will undoubtedly come to light.

It’s pretty elementary, after all — extending high-quality health coverage to more Americans will make the country healthier. That’s what happened under Medicaid expansion, which extended the program to Americans with incomes of up to 138% of the poverty level. Before, Medicaid was available only to the disabled, those at or below the poverty level or, for pregnant women or families with very young children, at 133% of the poverty level.

Former Republican Gov. Brian Sandoval understood the value of expansion when, under his leadership, the state adopted it during the first year the opportunity became available, in 2014. Within virtually a blink of an eye, the number of Nevadans covered by Medicaid zoomed to 631,128 from 332,560. We posted the nation’s largest decrease in uninsured children — cutting that number to 6.8% in 2016 from 14.9% in 2013.

This has not only spared the ill and their families from physical and emotional trauma, it’s also very sound fiscal policy. Healthier societies are more productive and have stronger economies than societies where people are sick. These benefits last generations, too. To use a single example: If you save the life of a parent, the children have the benefit of a stable home and better prospects for education and being productive in their own lives.

So solid health care helps to stabilize the entire society.

Keep in mind that Nevada could have passed on expansion. Many states did, taking advantage of a Supreme Court ruling that allowed them to effectively opt out of Medicaid expansion without risking their federal funding for the program.

Their reasoning, shamefully, was almost entirely political. The expansion was a provision of the Affordable Care Act, which many Republican-controlled states wanted desperately to sabotage.

To Sandoval’s credit, he went against his party’s grain. And since then, Nevada voters have supported a whole host of candidates who support Medicaid and the ACA.

Meanwhile, 34 other states and the District of Columbia have followed our lead. Medicaid expansion has been a terrific success, and a popular one at that.

As we’re seeing now, Nevadans exercised excellent judgment in getting on board early and defending the program since. We’re much better off than we were five years ago.

It goes to show how good things can happen when the focus is on people’s well-being instead of political ideology.