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States that have expanded their Medicaid enrollment in recent years saw a significant decline in mortality rates among older adults, new research finds. Such findings could influence whether states opt to expand Medicaid coverage under the Affordable Care Act, researchers note.

In their analysis, investigators compared mortality rates in states that expanded Medicaid coverage since 2000 — Maine, New York and Arizona — to neighboring states that did not — New Hampshire, Pennsylvania, Nevada and New Mexico. They observed a 6% drop in the mortality rate in states with expanded coverage. The decrease was particularly notable in older adults, minorities and residents of low-income counties, according to study authors.

The Harvard University researchers note that this finding is consistent with the outcomes of Medicaid expansions in the 1980s. The study come as state governors weigh the decision to expand Medicaid coverage to adults with incomes up to 133% of the federal poverty level, a provision of the ACA which the Supreme Court ruled as optional. Medicaid pays for the bulk of skilled nursing facility care.

“Policymakers should be aware that major changes in Medicaid — either expansions or reductions in coverage — may have significant effects on the health of vulnerable populations,” study authors note.

The findings were published Wednesday in the New England Journal of Medicine Wednesday.