The Affordable Care Act has not helped health outcomes, and may even have led to increased mortality rates, a new study by the right-leaning Manhattan Institute concludes.
The increase in the insured rate is almost exclusively due to Medicaid expansion, which is not good insurance, according to Oren Cass, a senior fellow with the Manhattan Institute.
Cass studied health outcomes, the mortality rates, and crunched the numbers of those insured under Medicaid and through private plans.
"I think in the debate over Obamacare, one of the arguments coming from Democrats was that it would save tens of thousands of lives, and that if repealed tens of thousands would die," Cass told Patient Daily. "To anyone opposing it, the argument that has come up again and again is that if they oppose it, they are condemning all these people to death."
But these arguments are based on a serious misunderstanding of what Obamacare did, according to Cass.
"It did not expand private coverage but massively expanded Medicaid," he said. "You take that expansion and they assume there is better coverage, but Medicaid is not good insurance. No lives are saved at all. "
Cass concluded that public health trends have worsened following the implementation of the Affordable Care Act, with 80,000 more deaths in 2015 than had mortality continued declining during 2014-15 at the rate achieved during 2000-2013.
Economic recovery, not the ACA, has driven changes in private insurance coverage, Cass calculated. From 2007 to 2010, total employment fell 5.5 percent and private insurance coverage fell 7 percent; from 2010 to 2015, total employment rose 8.8 percent and private insurance coverage rose 9.5 percent.
The share of non-elderly Americans with private health insurance fell from 66.8 percent in 2007 to 65.6 percent in 2015, but the share of those enrolled in public insurance, primarily Medicaid, has increased from 18.1 percent in 2007 to 25.3 percent in 2015.
"If you look at what has happened, rather than lives saved, the conclusion is that the ACA has increased fatalities," Cass said, adding that this is the opposite to the argument made by supporters of Obamacare.
When Medicaid is expanded, there is no increase in doctors but longer waits and less care, Cass argued. He supported the changes to Medicaid contained in the proposed American Health Care Act.
