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"It's a fair question." For now, though, it's the best estimate we have. And if the ACA is repealed, "repaired," or replaced with something else in a patchwork across the US, we may never have a clearer result. *Footnote: A word on the randomized trials about health insurance and why they can't tell us much about Obamacare and mortality It would be an oversight not to mention that some of the best data out there on the impact of health insurance comes from Oregon . There, researchers tracked what happened to the winners and losers of a state lottery that offered Medicaid to 10,000 randomly selected Oregonians in 2008. This is the closest we have to a randomized trial on health insurance, which was certainly a scientific breakthrough: There had never been a randomized trial the gold standard study methodology that gave some people insurance and withheld it from others, since that would be unethical to do. So this study was a first. But unfortunately, the Oregon research can't tell us all that much about mortality. The population the researchers looked at was too small (10,000 people compared with the 270,000 in the Massachusetts study), and it lasted for only two years, which isn't enough time to evaluate the mortality impact of Medicaid versus no insurance, Harvard's Katherine Baicker, a lead author on the study, said over email. "While the Oregon study gives what I think are the most scientifically robust findings on the outcomes it examines, it does not have sufficient sample size to detect the changes in mortality that one might expect to find from Medicaid expansion." Still, added CUNY's David Himmelstein , "[i]ts findings of small although not statistically significant improvements in blood ครีม ทา หน้า ผู้หญิง pressure and diabetes control, Framingham Risk score, and substantial statistically significant improvements in depression, are consistent with estimates from other studies of decreased mortality from gaining health insurance." The RAND Health Insurance Experiment , which ran from 1974 to 1982, is another important randomized trial on health insurance.
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