Remember those death panels, how the ACA was going to kill lots of Americans (especially your grandmother)? I’m still enraged at the idea, goverment just killing old people. Terrible thing, and the outrage about them on the right was a wonder to behold, one of Sarah Palin’s heroic fact-free moments.

Killing young people, though, is another story, and Republicans are generally fine with it. About 13 million people under 65 would be eligible for expanded Medicaid in the states that are refusing it (9 million live in the states that have signed up). Since Massachusetts expanded health insurance to everyone, the death rate there, already below the national average, has fallen by about 3%, and the finding (attributing it mainly to health insurance expansion) seems pretty solid, especially as it makes sense theoretically. After all, what people do when they have insurance is get health care when they’re sick, and what health care does when you’re sick is usually to make you better, and being sick is what most people die from, duh. The national death rate is about 3% per year for ages 20-64 (the Medicaid expansion potential beneficiaries), so a 3% reduction would save about one in a thousand of those people.

Now there’s a real bunch of death panels: Republican state governments. The people denying their citizens this insurance are happy to kill 130,000 people over the next ten years to prove how conservative and grownup and serious they are (not to mention improving the character and self-reliance of the survivors and anyway, a lot of those poor people vote Democratic every extra year they’re alive). That’s probably an underestimate, because being insured gains more life-years among the poor, and the non-expansion states are mostly poor, like the whole South. Haven’t heard from Sarah about this, but I’m sure she’ll be on the case with all four grizzly bear feet.

[Cross-posted at The Reality-Based Community]

Michael O'Hare

Michael O'Hare is a Professor of Public Policy at the University of California, Berkeley.