The Affordable Care Act (ACA) provides health insurance to millions of people who lack health insurance coverage.

While the law offers some financial assistance to those who lack insurance, it’s not without its limitations: While the Affordable Care System is not free, it does not cover the full cost of medical care.

To address this problem, researchers have been developing novel methods to help people who cannot afford medical care stay alive.

The research has been done in partnership with the Center for Health Policy Research at Tufts University and the University of Pennsylvania.

In a paper published this month in the journal Health Affairs, researchers from Tufts and the Pennsylvania State University analyzed data from the Medicaid program, the Health Insurance Marketplace, and the Health Research Access Program (HRAP) to examine whether there is a “pre-existing condition exclusion” for women who cannot pay for their care out-of-pocket.

The researchers found that there was. 

Using a population of more than 1.5 million people who are enrolled in the Medicaid Program and 1.4 million people enrolled in HRAP, they found that the exclusion would reduce mortality by about 1.1 percent per year, or about 3,300 deaths per year.

This would save about $2,700 per person per year in premiums and out- of pocket costs, the researchers said. 

Researchers also found that a pre-existing disease exclusion would save a woman’s life if she had the following conditions: A pre-disposing uterus: Biphasic pregnancy or spontaneous abortion Branching or intrapartum hemorrhage Fibroids in the lower abdomen A pelvic inflammatory disease (PID) diagnosis of diabetes or hyperglycemia A heart condition A condition causing a stroke or heart attack A preexisting condition such as COPD A history of cardiovascular disease or high blood pressure A diagnosis of hypertension or diabetes A medical condition that makes it harder for a woman to control her blood pressure or her blood sugar level A physical condition such, for example, that requires medical care for a heart condition, COPD, diabetes, or high cholesterol A severe condition, such as severe depression or anxiety A serious illness that affects the brain or nervous system A chronic illness that can cause mental or physical impairment A death that occurs within a year after the diagnosis of a preexistent condition or if a woman dies from a serious condition in the first year of her life. 

The study found that excluding a woman who could not afford medical insurance would reduce her life expectancy by about 3.3 percent per day, or 4,500 lives per year when the exclusion is removed.

In other words, the study found a reduction of about 1,100 lives per day. 

What’s the takeaway? 

“This study provides important evidence that a policy of exclusion is a potentially cost-effective and beneficial policy for reducing the incidence of premature death,” the researchers wrote. 

While the exclusion could save a life, researchers said the research was limited because there was no data on how the exclusion affected mortality rates.

Researchers noted that women would have been better off without the exclusion.

“This finding should serve as a warning to policymakers and the public to consider the health consequences of exclusionary policies when making policy decisions about coverage or subsidies for health care,” the authors wrote.

“There are many potential costs to exclusionary policy.

For example, the exclusion of women who are pregnant or have preexisted conditions from coverage would result in higher costs to insurance issuers.

In addition, the policy would likely lead to a decrease in the number of people enrolled or in insurance and a decrease to the quality of care provided to people with preexistential conditions.”

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