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Life without Insurance, Might Mean No Life at All

One of the key reasons why the Republican effort to repeal and replace the Affordable Care Act failed was that their proposals would likely have stripped millions of Americans of health insurance.  At first glance, losing your health coverage may not appear to be a terrible loss; after all, all Americans can still visit an emergency room even if they lack insurance.  New studies, however, suggest that losing health insurance may dramatically shorten your life.

After President Barack Obama passed the Affordable Care Act in 2010, more than 20 million Americans obtained access to health care either through subsidized private plans found on the newly established health insurance exchanges or through Medicaid. More than 14 million of these new health insurance enrollees obtained their coverage through Medicaid, a federal insurance program that primarily serves the poor and disabled.

Both the bills in the U.S. House of Representatives and the U.S. Senate would have rolled back the expansion of Medicaid that the ACA implemented.  Many of the poorest and sickest would have lost their health insurance and, therefore, access to life-saving treatments.  In effect, any plan to take health insurance from people would doom them to a much shorter lifespan.

Medicaid Expansion

Health Coverage Saves Lives

A report published in the American Journal of Public Health argues that 45,000 Americans die each year because they don’t have health insurance. Sponsored by Harvard Medical School, this study looked at 30,000 people, and found that those who didn’t have health insurance had a 40 percent higher chance of death than those who did have health insurance. The researchers then extrapolated this ratio to the broader U.S. population, and determined that about 44,800 people died in 2005 because they lacked affordable access to health care.

However, other studies have examined the U.S. uninsured population and come up with different figures, suggesting that the link between health insurance and early death may be less concrete than the Harvard report indicates.  In one study, it was estimated that 18,000 people die from lack of health coverage, while another estimates 22,000.

Obamacare Coverage

Why Health Insurance Matters

Although the exact numbers are not the same, researchers do agree that uninsured are at greater risk. At the heart of the matter is how much more care the insured receive than those without insurance. For many people without insurance, they may be suffering from chronic conditions like diabetes, high blood pressure or hepatitis without knowing.  Even if these conditions are diagnosed, without insurance, they may not have the physician’s advice or prescription medications necessary to properly manage their condition. Ultimately, these improperly treated chronic conditions are likely to lead to health complications that may significantly shorten lives.

Even for healthy people without any major health issues, coverage provides major health benefits.  Having a physician monitor your general health enables you to remain at optimal health and more quickly detect any emerging problems. For example, if your blood pressure rises, your physician may investigate your diet and recommend dietary changes, more exercise or pharmacological therapies.

Furthermore, there is mounting scientific evidence that having health insurance produces mental health benefits. One study examined the effects of getting Medicaid insurance on a group of almost 30,000 Oregonians. Of the 30 percent of this population that were granted health coverage, there was an almost 9 percent decline in depression, despite no significant increase in anti-depressant usage.  The lower levels of depression, anxiety and stress were attributed to greater peace of mind in having the financial security of health insurance coverage.

Health Insurance

Some Criticism

Although there is a growing body of scientific research that links health coverage with improved wellbeing and longer lifespans, there are some critics that argue that many of these studies are flawed. As mentioned earlier, there is considerable variation in how great the risks are in going uninsured, and there are even some studies that suggest that there is no statistical difference in mortality rates between insured and uninsured.

To better understand some of the criticisms directed at these studies, you must first take a closer look at how they were conducted.  Like almost all epidemiological studies, the accuracy of the results depend on the size and characteristics of the studied population.  Typically, the larger the population, the more accurate the study, but there are logistical limitations that often bound these kinds of studies.

To compensate for size restrictions, researchers try to use a group that closely resembles the U.S. population, but, once again, it is almost impossible to produce an ideal study population.  This is where many critics argue these studies are flawed.  They argue that uninsured and insured populations don’t reflect the age, gender, education, income and other features of the wider population, creating an imbalanced model.

For example, if there are too many older people in an uninsured population, that may skew the study results.  Although there are some older Americans who choose to go without health insurance, usually, it is younger and healthier people who opt out. However, if a study population of uninsured has too many older people—who are statistically more likely to have health problems and encounter a fatal health episode—then the study may not accurately predict the mortality rate among uninsured Americans.

This has led to some analysts concluding that there is no reliable way to relate health coverage to a lower mortality. Even among the medical community there is some support for studying the issue more rigorously due to ongoing uncertainty about the accuracy of currently available evidence.

More importantly, many critics point out that the risks posed by lacking health insurance may be mitigated in other ways.  They argue that the 40 percent additional risk that one study suggests may be reduced by safer habits like a strong exercise regimen, defensive driving or cessation of smoking.

If you would like to learn more about how health insurance can positively impact the lives of you and your family, please talk to one of the highly experienced insurance professionals at Boost Health Insurance.


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