Affordable Care Act Resulted in Fewer Cardiac Arrests

Under the Affordable Care Act (ACA), millions of previously uninsured Americans gained coverage through the individual marketplaces and Medicaid expansion. The law requires all Americans to have health insurance or face a penalty.

A new study discovered significantly fewer cases of cardiac arrests among individuals who purchased health insurance through the ACA compared with before the health law, according to the Journal of the American Heart Association.

Cardiac arrest occurs when the heart suddenly ceases functioning and can result in death if immediate medical attention is not received. More than 350,000 cardiac arrests occur out of hospitals annually in the United States, which highlights the importance of prevention.

“Cardiac arrest is devastating and under-recognized cause of premature death for both men and women older than 45 years,” said study lead author Eric Stecker, MD, MPH. “Health insurance allows people to engage in regular medical care, which is crucial for the prevention of cardiovascular disease and the diagnosis and treatment of conditions that can cause cardiac arrest.”

In the study, the authors examined emergency medical services provided to patients who experienced out-of-hospital cardiac arrests in an urban county in Oregon both before and after the ACA. The records were compared with Census Bureau data between 2011 to 2012 and 2014 to 2015, according to the study.

The authors discovered that the incidence of cardiac arrest among middle-aged adults was reduced after the health law was put into place.

The authors found that among newly-insured adults aged between 45 and 64, cardiac arrest was reduced by 17%; however, cases of cardiac arrest remained the same among older adults primarily insured through Medicare, according to the study. This finding is particularly significant because Americans aged 65 years and older are more likely to have stable health insurance.

“These findings underscore the important role of prevention in the battle against sudden cardiac arrest, which affects almost a thousand Americans every day,” said senior author Sumeet Chugh, MD. “Less than 10% of these patients make it out of the hospital alive, so by the time we dial 9-1-1 it is much too late. For this reason, effective primary prevention is vital.”

While the results show a link between health insurance and lower risk of cardiac arrest, the authors caution that they do not prove cause and effect, according to the study. Additional studies that include more diverse patients are necessary to confirm the link, according to the authors. The future studies should also look at social and other factors that contribute to health.

“It is critical to more comprehensively identify the health benefits of insurance and to carefully consider public policies that affect the number of uninsured Americans,” Dr Stecker said.