AHA Stat Blog: Study Highlights New Evidence that Expanding Health Care Coverage Reduces Violence

We talk a lot about how health insurance coverage improves people’s health and increases their financial security. But health coverage also seems to help fight crime.

Jacob Vogler, a PhD, economics student at the University of Illinois, tracked figures from the FBI Uniform Crime Reports and the Census Bureau since the Affordable Care Act (ACA), which allowed states to expand their Medicaid programs to all adults up to 138% of poverty. 

He also whittled down to a more granular level, looking at the crime rates in counties in Medicaid expansion states that saw the biggest increases in coverage. 

Vogler found that incidents of reported violent crimes decreased 5%, per 100,000 people, in Medicaid expansion states compared to non-expansion states. Incidents of property crime decreased by 3%. Homicide, aggravated assault, robbery, and vehicle theft all saw statistically significant declines. And counties that saw bigger coverage gains saw bigger crime reductions: A 1% gain in coverage correlated to a 0.7% drop in violent crime.

Vogler estimates that the ACA’s Medicaid expansions resulted in cost savings of $13.6 billion due to the reduction in crime. 

The author cited previous studies that found 90% of people entering local jails were uninsured before 2014. 

“While high rates of uninsurance and criminal behavior separately impose heavy burdens on individuals and communities in the U.S., statistics also indicate that the issues are closely linked,” said the study. “The analysis reveals economically meaningful and robust evidence that expanding health insurance eligibility reduces rates of reported crime.”

Reducing violence and property crime, while improving access to care, is a better outcome for everyone. Vogler’s study makes the case that the social benefits of expanding health care coverage far outweigh its costs, and, in fact, is one of the smartest investments society can make.