Did Obamacare Really Save Lives?

Tyler Durden's picture

Authored by Robert Murphy via The Mises Institute,

One of the popular objections to the GOP proposals to reform health insurance markets is that the Affordable Care Act (aka “ObamaCare”) saved thousands of lives per year, and hence that tinkering with ObamaCare will literally kill lots of people. For example, Hillary Clinton tweeted out:


Now to be sure, even if the claim were true, it still wouldn’t follow that coercive redistribution of wealth was morally justified. However, as happens so often in political controversies, libertarians don’t have to choose between property rights and tolerating widespread suffering. Believe it or not, the data suggest that if anything, ObamaCare actually caused more Americans to die.

None of what I write in this piece should be construed as an endorsement of the GOP bills. But the claim that they would “kill lots of people” is not valid.

Oren Cass’s Amazing Takedown

The researcher who alerted me to these awkward facts was the Manhattan Institute’s Oren Cass. Cass makes three important points in his recent study:

#1. The various estimates of the alleged lives saved under ObamaCare were not based on actual mortality data. Rather, these pro-ObamaCare studies relied on previous episodes (such as the implementation of “RomneyCare” in Massachusetts) where the expansion of insurance coverage went hand-in-hand with improved health outcomes. Then, taking this correlation as a “fact,” the pro-ObamaCare researchers multiplied by the expansion of insurance under ObamaCare and came up with an estimate of how many Americans’ lives were saved.

Yet as Cass points out, this procedure is flawed. What the literature actually shows is that expansion of private health insurance coverage contributes to improved health outcomes. But under ObamaCare, the amount of private coverage went down relative to what we would have expected in the absence of the legislation. What really drove the increase in insurance coverage under ObamaCare was the expansion of Medicaid. And here, it is much less obvious that this is a boon for health outcomes, as the now infamous Oregon experiment shows.

Looking at the Aggregate Data

#2. Now that we’ve undercut the foundations of the pro-ObamaCare figures, we can turn to the actual mortality data from the U.S. After all, as Cass says, if ObamaCare really has been avoiding tens of thousands of deaths per year, we should see that in the data.

And yet, we see the opposite. Although the ACA passed in 2010, the full expansion of insurance coverage didn’t kick in until 2014. So the relevant metric is to see what happened to (age-adjusted) mortality rates before and after 2014. Lo and behold:

U.S. Age-Adjusted Mortality Rates per 100,000 (Annual, 2002–2015)

Source: CDC WONDER Database

2017.06.27 ACA and Mortality.png

As the figure shows, if we control for the aging of the population, the mortality rate tends to fall over time. However, for whatever reason, after falling in 2014, the mortality jumped back up in 2015, erasing all the gains since 2013.

To see that this isn’t some artifact of this data set, we can cross-reference this information with life expectancy. Some readers may have been aware that researchers were alarmed in late 2016 when the latest figures showed U.S. life expectancy falling “for the first time in decades.”

Looking at the State-Level Data

#3. But now we come to the third and most devastating component of the Cass study. He is intellectually honest and concedes that the uptick in mortality in 2015 could be a fluke, or it could be a genuine problem due to something other than ObamaCare. For example, there is a festering opioid epidemic in many parts of the US, so perhaps it was just bad luck (for Obama’s legacy) that this public health crisis happened to hit right when his signature legislature fully kicked in.

Yet Cass points out that we still have a pretty good control group to assess the specific impact of the Affordable Care Act’s boost to coverage. Specifically, only 31 states (plus DC) expanded Medicaid under the ACA, while the other 19 states rejected the offer. So if it’s true that the ACA really did “save lives” relative to what otherwise would have happened, but that the absolute mortality rate in the US went up because of some external problem (like the opioid crisis), then we should still expect see mortality rates jumping more in the “red” states that rejected Medicaid expansion.

And yet, as Cass points out in his study, we see the exact opposite. Namely, the states that took advantage of ObamaCare’s Medicaid expansion saw a worse impact on their mortality rates than the states that rejected the expansion.


Although I personally do not yet have a theory on the specific mechanism that may be responsible, I am confident in saying that the actual data do not support the breathless claims that rolling back ObamaCare will literally kill many thousands of Americans.

Fans of the Austrian school should not be shocked, though, to discover that having the federal government get more heavily involved in the health sector has apparently made things worse.


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Bill of Rights's picture

The word " Save " and Obamacare do not belong together.

earleflorida's picture

baby seals maybe....

because i know,


FrozenGoodz's picture

So repeal it and replace it with nothing ... that'll teach em

tmosley's picture

No government meddling is always better than any government meddling.

VinceFostersGhost's picture



Look at the VA......that's government healthcare.


Nuff said....

eclectic syncretist's picture

Olbombya: "you may not like it, but it probably saves lives.,,,,Ya goddamn right I ordered the code red!"

froze25's picture

If a Dem or RINO (we know who they are) Globalist says it, we know they are lying.

playit's picture

I'm making over $7k a month working part time. I kept hearing other people tell me how much money they can make online so I decided to look into it. Well, it was all true and has totally changed my life. This is what I do... www.jobproplan.com

Bill of Rights's picture

Hey retard....its called FREE MARKET for a reason. Seeing what you wrote there Ill wager $1000 cash your receiving some sort of .Gov benefit...make it $2000....

Katos's picture

I READ that since Obama care came into existence, "STATINS " HAVE BECOME THE NUMBER ONE PRESCRIBED DRUG IN THE WORLD?? Your brain uses 25% OF the cholesterol YOUR body takes IN AND THE coleserol is essential for proper brain function! So what happens to the brain WHEN you take STATINS , which ELIMINATE  cholesterol from your body?? Dementia, Alzheimer's, Parkinson's! ALL THESE are going through the ceiling as the elderly get soaked for their life savings, because they become mentally unable to function? THINK TWICE BEFORE YOU LET YOUR DOCTOR FORCE STATINS ON YOU!

Billy the Poet's picture

So repeal it and replace it with nothing ... that'll teach em

What would be so terrible about going back to the way things were before Obamacare when four out of five people were happy with their medical care?


Gallup: 80% satisfied with health care, 61% with insurance



Thurmonster's picture

Good idea. Get the government out of the health insurance business all together. But it won't teach 'em a thing. The Leftists rulers already know good and well what their destructive policies are doing, but their subjects will only accept the reality as dictated by their masters no matter what they experience personally.

toady's picture

Save? Obamacare is all about guaranteeing and/or subsidizing insurance profits. .. nothing in therr about saving lives....

XqWretch's picture

does anything .gov does save lives?

Arnold's picture

Yet they are pulling out of vast areas of the country, and crying poverty.

WillyGroper's picture

i know someone using (O)care.

premiums started @ $400 mo & were then lowered to $300...thanks to FNMA/FRE shareholders.

nothing more than another theft angle/transfer of wealth.


shocktherapy's picture

It amazes me that Higher IQ people would blame either Party, when its both ! 


HillaryOdor's picture

It's neither.  It's the entire population.  It's the culture.  It's all of us, or the vast majority of us at least.  It's you, you thinking that deregulation is a bad thing and that regulation actually helps you. Educate yourself.

It's not a few politicians.  Put others in their place and you get the same thing.

. . . _ _ _ . . .'s picture

So, this baby seal walks into a club...

realmoney2015's picture

Do insurance and certain politicians lives count? I'm sure their lives have improved

Putrid_Scum's picture

One of my favourite tunes is Wrong Side of Heaven - Five Finer Death Punch


Is the situation as bad as this video depicts?

(I'm writing from Ireland.)


Putrid_Scum's picture

Gee, some people,

Art is, in my opinon, a far better descriptor of reality than rational arguments.


Handful of Dust's picture

The fact that Obama and Pelosi only targeted the middle class private sector to bankrupt, (and exempted all government employees and most unions) shows it was a POS legislation from the start.


If the health insurance was so wonderful, it would have included government officials and at least governmen tunion employees.

but it did not.

SilverRoofer's picture


it hasn't done SHIT for me but make all of my health care cost go up by more than Tripple 

ebworthen's picture

Obummercare killed my savings account.

e_goldstein's picture

Actually, that was the FED.

Obummercare just cremated the remains.

shocktherapy's picture

Dear Higher IQ people when will you stop this ?!


Reckless stock trading leaves Congress rife with conflicts
Falconsixone's picture

Experts say yes and no.

earleflorida's picture

define 'Expert' ?

yes and no are the same answers for postulating a paradox already inverse'd to be an exact enigma science that never truly was?!?

Falconsixone's picture

Double speak. Depends on whether the expert is thinking about pumping his secretary's sweet ass when he says yes?

DarthVaderMentor's picture

Glad to hear that because the dead that Obamacare killed can't say anything

GeezerGeek's picture

But they can still vote, assuming of course they were Democrats.

mary mary's picture

If you line up all the experts, they point in different directions*. 

*Except the ones who are paid to all point in the same direction.

Sledge750's picture

If you line up all the "experts", they're easier to shoot!


Works for bankers and politicians too!

MCDirtMigger's picture

I suspect you shake your 'experts' and turn them over to look at their response through a plexiglass window on the bottom of an eight ball.

Peter41's picture

The gov't healthcare record is reflected quite well in the VA heath care system. Top down, bureaucratic governance kills in the healthcare sphere.

Doom and Dust's picture

It did not. But it made lives more expensive.

Any US specialized actuarians here? I'd say losing a pool of poor but healthy payers is a net loss no?

DarthVaderMentor's picture

If Obamacare didn't kill white middle class people, then the intentional VA negligence and incompetence made up for it.

az_patriot's picture

Obamacare only benefits a very small number of extremely low-IQ vagrants, hooligans, and illegals, and is nothing but wealth redistribution in disguise.  There's nothing beneficial about it all, and those very small number of people can be parked under Medicaid or Medicare, and it would be a WHOLE lot cheaper.

kalboking's picture

Low iq? Coming from a Trumptard arizonian flag waver. Lol the irony

CompleteAphasia's picture

You can trust MSM to ignore this though

VinceFostersGhost's picture


Have to ignore it.......the Russians are coming!

mary mary's picture

I bet Obamacare resulted in increases in medicine costs.  I know my Medicare Part B pharmaceutical insurance provider increased my deductibles.  I'm not on Obamacare, but I suspect that Obamacare gave my insurer the "green light" it was waiting for.  To increase everyone's deductibles.

I also think this is the primary reason Congress is having such a hard time repealing Obamacare: Big Insurance, Big Pharma, and Big Hospitals all contribute enormous amounts to political campaigns.  They also spend enormous amounts on television advertising, and MSM responds by endlessly propagandizing that repealing Obamacare would be "cruel and heartless".  Yeah, sure, "cruel and heartless" to the bottom lines of the CEOs of Big Insurance, Big Pharma, and Big Hospitals.

WillyGroper's picture

if i'd have used my "insurance," my last script would have been $30.

because i hate cvs, i use another, paid cash $2.90.

of course they data gather as that puts you as "non-compliant."

non-compliant for their obscene ass raping.

way cheaper not to play.

hooligan2009's picture

a politician has no clue about whether a left or right wing biased policy works or does not work.

in other words, there neither is now, or has been in the past, ANY policy that shows that government intervention in health care provision provides a more favorable outcome IN TERMS OF THE MORTALITY RATE.

however, this does not cover other health issues like cancer, diabetes or opiod related diseases.

usually, there is a point to an action. politicians, as usual, have no point/objective  - or a metric by whch to judge any kind of success.

in the meanwhile, the killer drugs masquerading as treatment - opiods - go on killing and maiming the organs of americans completely unchecked and, in fact, approved by the corrupt and useless FDA.

so does the price gouging my drug companies of drugs that cost a few cents to produce yet are charged at hundreds if not thousands of dollars.

and still, those states that provide better health care than other states for a cheaper price cannot treat patients from other states - because of politicians.

drain the fucking swamp already and sentence libtard socialists to health treatment in the most expensive states with the poorest quality (and highest taxes - funny that hey?) .


Thebighouse's picture

obummer was stalinesque in the number of people he killed......the nobel peace laureat smuck himself.