Free roaming health clinics, like the one these West Virginians are waiting for, aren't going to go away.

Free roaming health clinics, like the one these West Virginians are waiting for, aren't going to go away.

"We predict that many low-income women will forego recommended breast and cervical cancer screening; diabetics will forego medications and all low-income adults will face a greater likelihood of depression, catastrophic medical expenses and death," researchers wrote in the study, which was released on the website of the journal Health Affairs. "We calculated the number and characteristics of people who will remain uninsured as a result of their state's opting out of the Medicaid expansion, and applied these figures to the known effects of insurance expansion from prior studies," lead author Samuel Dickman said. "The results were sobering. Political decisions have consequences, some of them lethal."

Twenty-five states have refused to expand Medicaid under the Affordable Care Act. That leaves millions of people in the gap between being poor enough to qualify for existing Medicaid, and too poor to qualify for the subsidies available to buy private insurance on the health exchanges. Refusing the expansion is a political decision by Republican state lawmakers that will have a big economic impact for those states. What it will also cause, according to a new study from Harvard University and the City University of New York, is eight million people remaining uninsured, and up to 17,000 premature and avoidable deaths The authors break it down more in a post at Health Affairs. The sheers numbers of those not receiving screenings and treatments: 712,037 fewer diagnoses, and treatment, of depression; 240,700 people suffering "catastrophic medical expenditures"; 422,553 diabetics not receiving medication; 195,492 fewer mammograms; and 443,677 fewer pap smears. "Expansion would have resulted in an additional 658,888 women in need of mammograms gaining insurance," the authors say, "as well as 3.1 million women who should receive regular pap smears."

That's not counting the millions of idiotic conservatives who are opting out of insurance just out of spite over Obama. They'll still contribute to the avoidable death toll, and it will also be irrational.