The death toll from blocking Medicaid expansion

A study published today in the journal Health Affairs calculates the impacts of states' refusal to expand Medicaid to more low-income residents under the Affordable Care Act.

It finds the death toll will be considerable -- especially in the South, where most states are rejecting expansion.

Almost 48 million U.S. residents were uninsured in 2012, a number that is expected to decrease by 16 million after ACA is fully implemented. Of the remaining 32.2 million uninsured, nearly 8 million would have gotten coverage if their state had opted in to the expansion.

The study's authors, all medical professionals, estimate the number of adverse outcomes, including deaths, that could have been avoided by Medicaid expansion.

Among all the states rejecting expansion, the authors calculate the resulting death toll at between 7,115 and 17,104.

Six of the 10 states with the highest number of estimated deaths are in the South:

1. Texas (1,840 to 3,035 deaths)
2. Florida (1,158 to 2,221 deaths)
4. Georgia (561 to 1,176 deaths)
5. North Carolina (455 to 1,145 deaths)
6. Virginia (266 to 987 deaths)
7. Tennessee (284 to 759 deaths)

The other states with the highest expected death tolls are Pennsylvania in third place and Indiana, Missouri and Wisconsin in eighth, ninth and 10th places respectively.

Elsewhere in the South, the death toll from Medicaid non-expansion is expected to be between 284 and 759 people in Tennessee, 249 and 542 in Louisiana, 215 and 562 in Alabama, 209 and 551 in South Carolina, and between 141 and 343 people in Mississippi.

The other impacts calculated by the authors include the number of fewer depression diagnoses and the number of individuals who will face catastrophic medical expenses.

To read the study, which details how the numbers were calculated, click here.