Rob: What I'm trying to wrap my head around is that half a million people in this study got expanded coverage and it saved about 2500 lives, right?
Dr. Sommers: Yep.
Rob: So, if you extrapolate out to 16 or 17 million, it's going to be 32, 33, 34 times that. 75,000 or more people--lives will be saved.
Dr. Sommers: Your math is right. It's not necessarily clear that the overall national results would be exactly the same as what we saw at the state level and there are several reasons for that. One, is that, as I said each state is a little bit different in terms of how it runs its Medicaid program and who enrolls. So, it could be that other states won't have quite the same impact. And the other factor is that this federal expansion is actually going to be even bigger than the state ones were and so, while on the one it means you have more people enrolled, our suspicion is that the first people that sign up for Medicaid expansion are the ones who are the sickest, who really need help the most. And so as you start to add more people later on in a bigger expansion, they may not get quite as much bang for the buck, but still we'd expect to see a significant benefit. So, it's hard to fix it to an exact number but it certainly would be far greater than the 2500 we saw in just three states.
Rob: Now, there are some states that are talking about not signing up, like Texas, I believe. Right?
Dr. Sommers: Yep. At least five or six states that their governor's have said they think they're unlikely to do the expansion.
Rob: So, what your study suggests, it seems to me, would you agree, is that if these governor's decline to sign to up, potentially thousands of people in their state are going to die that might not have died because the study shows it?
Dr. Sommers: You know, it certainly--that's--our findings provide evidence that expanding Medicaid saves lives and so if a state chooses not to do that we would definitely be worried that they're leaving some adults without any coverage who will have worse health and some who will die prematurely. So, that's certainly the policy implication--one of the key policy implications of our study and we think that this is really useful evidence for states to take into account.