Research links health insurance to lower mortality

One of the major ways that having insurance lowers mortality is by facilitating the diagnosis and treatment of high blood pressure, according to a new research review. (Getty/AndreyPopov)

The evidence is clear that health insurance helps save lives, according to new research that resonates even more amid attempts to repeal and replace the Affordable Care Act.

That new research is a comprehensive review of studies published this week in the Annals of Internal Medicine by Steffie Woolhandler, M.D., and David U. Himmelstein, M.D. It updates a 2002 Institute of Medicine study, which similarly concluded that lack of insurance increases mortality.

Looking at several new studies that have come out since that time, the researchers say the additional evidence “strengthens confidence” that the original study’s conclusion is correct.

One of the major ways that having insurance lowers mortality is by facilitating the diagnosis and treatment of high blood pressure, the review notes. Several studies cited in the review, for example, show that uninsured and underinsured Americans are less likely to have their hypertension diagnosed and that eliminating financial barriers to hypertension care decreases all-cause mortality.

In addition, other recent studies that were not part of the review support the conclusion that insurance coverage improves survival rates for specific conditions and improves several health status measures, the researchers note.

In fact, a recent piece in the New England Journal of Medicine contends there is “strong evidence” that greater health insurance coverage is linked to better health outcomes—though it also notes that increased care access and utilization can mean greater costs.

Woolhandler and Himmelstein, meanwhile, admit that their review has limitations, noting that in most cases, randomized, controlled trials aren’t possible. “Hence, policy debate must rely on the best evidence from observational and quasi-experimental studies,” they write.

But the two researchers, who co-founded Physicians for a National Health Program—which advocates for a single-payer system—say their review still underscores the potential consequences of ACA repeal attempts. The Congressional Budget Office has estimated the Senate’s healthcare bill would increase the number of uninsured individuals by 22 million as of 2026.

“Thousands of people are already dying each year because the Affordable Care Act has left 28 million uninsured,” Woolhandler said in a statement. “The Republican health reform bills would increase that death toll.”

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