Gaining insurance coverage improves individuals' health, happiness and financial stability, while increasing the amount they spend on health care, according to a continuing study of a 2008 effort to expand Medicaid coverage in Oregon, the New York Times reports.
The Oregon Health Study -- which involves researchers across myriad institutions, including Harvard, Massachusetts Institute of Technology and the National Bureau of Economic Research -- examines the effect of Oregon's decision to open its Medicaid program to low-income adults in 2008 through a lottery system.
Overall, 89,824 state residents entered the lottery to gain access to Medicaid. According to the Times, the lottery turned Oregon into "a laboratory for studying the effects of extending health insurance to people who previously did not have it."
Compared with residents who applied for the lottery but did not obtain coverage, those who received health insurance via the lottery are:
- More likely to describe their health as good;
- More likely to describe themselves as being happy;
- 25% less likely to have unpaid medical bills referred to a collection agency; and
- 40% less likely to borrow money to cover medical expenses or skip payments on other bills.
However, the study also found that the average Oregon resident who obtained insurance through the lottery spent about $778 annually, or about 25%, more on health care than residents who applied for the Medicaid lottery but did not obtain coverage.
According to the Times, interviews with study participants suggest that insured and uninsured residents use health care differently. For instance, many lottery winners regularly visited a primary care physician, while few uninsured residents said they regularly visited a physician.
Katherine Baicker, a Harvard economist who worked on the study, said, "The study put to rest two incorrect arguments that persisted because of an absence of evidence." She added, "The first is that Medicaid doesn't do anything for people, because it's bad insurance or because the uninsured have other ways of getting care. The second is that Medicaid coverage saves money. It's up to society to determine whether it's worth the cost" (Lowrey, New York Times, 6/22).