We use large-scale federal survey data linked to administrative death records to investigate the relationship between Medicaid enrollment and mortality. Our analysis compares changes in mortality for near-elderly adults in states with and without Affordable Care Act Medicaid expansions. We identify adults most likely to benefit using survey information on socioeconomic status, citizenship status, and public program participation. We find that prior to the ACA expansions, mortality rates across expansion and nonexpansion states trended similarly, but beginning in the first year of the policy, there were significant reductions in mortality in states that opted to expand relative to nonexpanders. Individuals in expansion states experienced a 0.132 percentage point decline in annual mortality, a 9.4% reduction over the sample mean, as a result of the Medicaid expansions. The effect is driven by a reduction in disease-related deaths and grows over time. A variety of alternative specifications, methods of inference, placebo tests, and sample definitions confirm our main result.

中文翻译：

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医疗补助和死亡率：来自相关调查和行政数据的新证据

我们使用与行政死亡记录相关的大规模联邦调查数据来调查医疗补助计划与死亡率之间的关系。我们的分析比较了在有和没有平价医疗法案医疗补助扩展的州中接近老年人的死亡率变化。我们使用有关社会经济地位、公民身份和公共计划参与的调查信息来确定最有可能受益的成年人。我们发现，在 ACA 扩张之前，扩张和非扩张州的死亡率趋势相似，但从政策的第一年开始，相对于非扩张者，选择扩张的州的死亡率显着降低。处于扩张状态的个人年死亡率下降了 0.132 个百分点，比样本平均值下降了 9.4%，由于医疗补助计划的扩张。这种影响是由疾病相关死亡人数的减少所驱动，并随着时间的推移而增长。各种替代规范、推理方法、安慰剂测试和样本定义证实了我们的主要结果。