A new study should put that argument to rest, permanently. The researchers found not only that the expansion of Medicaid under the Affordable Care Act brought appreciable improvements in health to enrollees, but also that full expansion nationwide would have averted 15,600 deaths among the vulnerable Medicaid-eligible population.

In other words, the 22 mostly red states that refused to accept expansion starting in 2014 caused 15,600 unnecessary deaths among their residents. “This highlights an ongoing cost to non-adoption that should be relevant to both state policymakers and their constituents,” write the study’s authors, charitably. Fourteen states are still holding out.

Medicaid expansion has been a litmus test for Republican governors and legislative leaders aiming to demonstrate their anti-Obamacare bona fides. They’re mostly in Deep South states and some havens of warped concepts of “freedom” such as Wyoming and South Dakota; some states such as Maine and Louisiana adopted expansion more recently when they replaced GOP governors with Democrats.

The authors of the new paper, a team led by Sarah Miller of the University of Michigan law school, recapitulate the sorry history of Medicaid expansion. The Affordable Care Act originally imposed it nationwide, with a provision that the federal government would pick up 100% of the expansion cost in its first three years, declining in stages to a permanent 90% share, where it stands now. That’s much more than the federal share of the traditional joint federal-state program, which covers mostly low-income households with children. The ACA expanded that to all households, including childless single persons and couples, earning less than 138% of the federal poverty level (or $17,236 for a single).

More about Sarah Miller & team finds that the expansion of Medicaid not only improves enrollee health, but the full expansion nationwide would’ve averted 15,600 deaths among the vulnerable Medicaid-eligible population. >