Nurses take a patient's glucose level and pulse at the Remote Area Medical (RAM) mobile clinic on Oct. 7, 2017 at the Riverview School in Grundy, Virginia.

The Center on Budget and Policy Priorities reports on a new study of all the states in the nation, demonstrating that those that took Medicaid expansion "saved the lives of at least 19,200 adults aged 55 to 64 over the four-year period from 2014 to 2017." The flip side is that 15,600 older adults died prematurely in the states that didn't accept the expansion in those years.

Following on other studies which have found that more low-income adults in Medicaid expansion states have used medication to control chronic conditions like heart disease and diabetes, researchers at the University of Michigan, National Institutes of Health, Census Bureau, and University of California Los Angeles have found clear evidence of a drop in mortality from these kinds of chronic conditions. The researchers focused on the group of pre-Medicare older Americans who have higher mortality rates and have a greater risk of premature death from treatable conditions. Using this group, they constructed a "novel dataset that links the American Community Survey—the largest federal survey with information on income, age, and other determinants of Medicaid eligibility—with administrative death records. The large sample lets them detect small changes in mortality that aren’t evident in other data." It also reaches a threshold that makes it statistically significant.

Their findings are significant: "In 2014 the annual mortality rate for low-income older adults in expansion states fell by about 9 deaths per 10,000 people, compared to similar adults in non-expansion states, with the impact growing each year to about 21 deaths per 10,000 people in year 4." That's how they determine the total numbers of avoided deaths and premature deaths in expansion and non-expansion states. They compared these numbers to National Highway Traffic Safety Commission data, and figured out that if all of the states had expanded Medicaid, as many lives would have been saved by coverage as by seatbelts.

That's 2,920 premature deaths in Texas that could have been prevented; 2,776 in Florida; 1,400 in North Carolina; and 1,336 in Georgia. What the study doesn't get into is how saving tens of thousands of lives by managing chronic conditions saved families and the states money that would have gone to critical or end-of-life care; how many people were able to remain active and in the work force; and how quality of life was affected for individuals and their families.

None of this matters to the Republican lawmakers who decided they had to refuse the expansion because Obama (or, for that matter, Chief Justice John Roberts, who engineered the whole debacle of states being able to turn it down under the law). Remember all of these numbers as the debate over Medicare for All heats up when we have a Democratic president again. And never forget that Republicans really don't give a damn if you live or die.