There’s a troubling myth circulating about Medicaid, especially in states that aren’t willing to expand. Former North Carolina Medicaid director Carol Steckel said it best:

“If I gave 700,000 people who don’t have health care coverage a Medicaid card in North Carolina, do you really think they would get healthier?”[i]

According to her – and other expansion opponents – Medicaid access doesn’t have an effect on health outcomes. But the facts say quite the opposite.

In 2012, Drs. Benjamin Sommers, Katherine Baicker, and Arnold Epstein studied the effects that Medicaid expansion had in three states that loosened their eligibility requirements between 2000 and 2005.[ii] Overall, they found that Medicaid expansion was associated with decreased mortality and delayed care, and increased coverage and self-reported good health.

The authors chose Arizona, Maine, and New York, which all expanded eligibility to childless adults with incomes up to 100 percent of the federal poverty level. They compared health outcomes five years before and five years after each state’s expansion, and used states with similar demographics who didn’t expand Medicaid as controls (New Mexico, New Hampshire, and Pennsylvania, respectively).

The states that expanded Medicaid saw a significant decrease in mortality – a relative reduction of 6.1 percent.[iii] They also saw a 21.3 percent decrease in delayed care, which has serious implications for health care facilities as well as the people who are no longer putting off medical care.

Unsurprisingly, counties with higher poverty rates saw the strongest effects. The reductions in mortality were also largest among non-white and older adults; the authors found no effect on people under 35.[iv]

“We found that new Medicaid enrollees were older, disproportionately minorities, and twice as likely to be in fair or poor health as the general population, all of which suggest higher mortality.”[v]

Arizona, Maine, and New York also saw an increase in the number of people who reported their health as “excellent” or “very good,” as well as an overall increase in Medicaid coverage.[vi]

These results are clear: expanding Medicaid makes people healthier. It increases access to health care and improves health outcomes for those who need it most. When making critical decisions that affect hundreds of thousands of North Carolinians, lawmakers shouldn’t let ideology get in the way of facts.

[i] Searing, Adam. (March 21 2013). “Baffling Comments from NC’s Medicaid director.” Raleigh News and Observer. Available at

[ii] Sommers, Benjamin D.; Baicker, Katherine; Epstein, Arnold M. (September 13 2012). Mortality and Access to Care among Adults after State Expansions. The New England Journal of Medicine. Available at

[iii] See note ii.

[iv] Ibid.

[v] Ibid.

[vi] Ibid.