Medicaid beneficiaries feel better, find regular physicians and are better able to maintain financial stability compared with low-income, uninsured people, according to a study of Oregon residents published by the National Bureau of Economic Research, the New York Times reports (Kolata, New York Times, 7/7).
Experts say the study is the first of its kind in decades and helps dispel criticism that Medicaid makes little difference in the well-being of low-income individuals.
Study authors -- including Amy Finkelstein, an economist at the Massachusetts Institute of Technology; Katherine Baicker of Harvard University and a former economic adviser to President George W. Bush; Jonathan Gruber, an MIT economist who has advised President Obama; and others -- examined the well-being of Oregon residents seeking Medicaid enrollment in 2008, when the state expanded the program.
At the time, the state could afford to add only 10,000 people to the program and held a lottery for eligibility. The lottery entrants presented researchers with an ideal opportunity to conduct a "randomized controlled trial" of a group of residents who were nearly identical, with the exception that some received Medicaid benefits and some did not.
Researchers enrolled the new Medicaid beneficiaries into the study along with the thousands who entered the lottery but were not selected to receive coverage (Rovner, "Morning Edition," NPR, 7/7).
Key Study Findings
Researchers found that compared with those without insurance, the Medicaid beneficiaries were:
- 35% more likely to visit a physician or seek medical help;
- 15% more likely to use prescription drugs; and
- 30% more likely to stay in a hospital.
In addition, Medicaid beneficiaries were 40% less likely to report declining health in the preceding year, while they had a 25% higher likelihood of reporting good or excellent health.
Meanwhile, study authors found that women with Medicaid coverage were 60% more likely to have mammograms. Beneficiaries were 20% more likely to undergo cholesterol assessments and 70% more likely to have a usual source of care than the uninsured, the study found. The authors also found that Medicaid beneficiaries were 25% less likely to have an unpaid bill sent to a collection agency and 40% less likely to borrow money or not pay other bills because of their medical costs (New York Times, 7/7).
Finkelstein said, "The bottom line is that Medicaid really matters in people's lives. There is a large concern out there about whether Medicaid actually makes a difference, and now we actually have evidence" (Alonso-Zaldivar, AP/San Francisco Chronicle, 7/6).
According to NPR's "Morning Edition," the study contradicts arguments that Medicaid is worse for individuals than having no health coverage at all. Critics of Medicaid also have argued that beneficiaries have trouble finding physicians and other health care providers who participate in the program because states often do not provide adequate reimbursement. However, the authors noted that they found no evidence that doctors were more likely to accept uninsured patients than Medicaid beneficiaries.
Finkelstein said the study should correct misleading findings from other, more limited Medicaid studies. She said older data have led to claims by Republicans that Medicaid can make patients sicker. She said, "But that's not because health insurance can make you sicker, it's because if you're sick, you're much more likely to go the extra mile or incur the additional expense to try to get health insurance" ("Morning Edition," NPR, 7/7).
Second Phase of Study
Researchers currently are conducting the second phase of the study, which measures and compares specific conditions such as blood pressure, cholesterol and weight, between Medicaid beneficiaries and those without insurance (New York Times, 7/7).