What if the ACA makes people healthier?

A researcher at the University of Indiana and her colleagues recently reported that the Affordable Care Act (ACA) Medicaid expansion program may have given low-income childless adults in the states that took expansion money one extra healthy work day per month.

Read: How has ACA affected people’s health?

Of course, that’s just one study. Another study might show something else.

But I think the results illustrate why analyzing how wonderful or terrible ACA is happens to be complicated.

Some people will look at high ACA public exchange enrollment figures and cheer at ACA’s success. Or, they’ll look at insurers’ lousy financial results in the individual commercial health insurance market and laugh at ACA’s failure.

Problems with the finances of specific ACA components are interesting but not necessarily definitive.

If health insurers are suffering huge losses because of chaotic federal ACA program administration, that’s a serious concern.

If health insurers are suffering losses mainly because they happen to be covering more sick people and poor people, that raises some questions:

• What kind of care would the newly covered people have gotten before?

• How much did society pay for the care that newly covered people were getting before?

• How much was lack of care affecting the economic productivity of the people who now have health coverage, and how much was those people’s reduced productivity costing society?

A careful analysis might (OK, probably will) show that ACA Medicaid expansion and the ACA public exchange program are inefficient ways to help poor, low-income people get and pay for care.