Health

Study: States with expanded Medicaid see fewer cardiovascular deaths

Report suggests access to doctors, medication, education improves health

Michael Randol, director of Iowa Medicaid, speaks at a May 10 town hall at Kirkwood Community College in Cedar Rapids. A new study found that states like Iowa with expanded Medicaid programs see fewer cardiovascular deaths than states without the expanded program. The study suggests that having more access to preventive measures — such as medications, doctors, education — decreases health issues faced by low-income people.  (Liz Martin/The Gazette)
Michael Randol, director of Iowa Medicaid, speaks at a May 10 town hall at Kirkwood Community College in Cedar Rapids. A new study found that states like Iowa with expanded Medicaid programs see fewer cardiovascular deaths than states without the expanded program. The study suggests that having more access to preventive measures — such as medications, doctors, education — decreases health issues faced by low-income people. (Liz Martin/The Gazette)

Iowa and other states with expanded Medicaid benefits see fewer cardiovascular deaths, according to a new study.

The study, by researchers at the University of Pennsylvania and Harvard University, looked at cardiovascular mortality rates in adults ages 45 to 64 from 2010 to 2016 in 29 states that had expanded Medicaid and 19 states that didn’t.

States with expanded Medicaid benefits were found to have 4.3 fewer cardiovascular deaths per 100,000 residents than states without Medicaid expansion.

The states with expanded Medicaid had 47.4 million middle-aged adults in 2014, “meaning 2,039 fewer total deaths per year in residents aged 45 to 64 years from cardiovascular causes,” the study said.

The findings suggest expanded Medicaid benefits influence outpatient care and access to care, the study said.

Dr. Sameed Khatana, one of the study’s authors and a cardiovascular medical fellow at the University of Pennsylvania, noted cardiovascular diseases are more common in individuals who are uninsured.

Dr. Phillip Horwitz, a clinical professor of internal medicine-cardiovascular medicine at the University of Iowa, said the findings make sense from a cardiologist’s perspective.

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There’s no definitive answer as to why lower-income people tend to have more cardiovascular problems, Horwitz said.

But the report suggests that having more access to preventive measures — such as medications, education and access to doctors — can decrease the number of health issues those people face.

Data in the study came from the federal Centers for Disease Control and Prevention and was used to find differences down to a county-by-county level. The number of physicians, poverty levels and other health-related points in each county were taken into account, Khatana said.

In 2014, 190.1 cases of cardiovascular mortality were reported per 100,000 residents in states with Medicaid expansion and 199.8 cases in nonexpansion states, according to the study.

By 2016, 199.2 deaths were reported per 100,000 residents in expansion states and 205.1 in nonexpansion states.

The study also found that 35.6 percent of low-income, middle-aged adults in expansion states were uninsured in 2010; the rate was 44.6 percent in nonexpansion states.

Between 2010 and 2016, expansion states had a 19.8 percent decrease in low-income adults without insurance; nonexpansion states saw a 13.5 percent decrease.

With the Affordable Care Act, Medicaid in 2014 underwent its largest expansion since the program started, Khatana said.

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This study is one of the first that examines the effects of Medicaid expansion on cardiovascular mortality.

“Changes on health outcomes (with Medicaid expansion) hasn’t been looked at as much,” he said.

Studies such as this one, he said, can inform people about the potential health outcomes from programs like Medicaid.

“This kind of research is important since health care is complex,” he said.

Today, 36 states and the District of Columbia have expanded Medicaid benefits.

l Comments: (319) 398-8342; kayli.reese@thegazette.com

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