Medicaid Coverage 'Substantially' Improves Access to
THURSDAY, July 7 (HealthDay News) -- Expanding Medicaid coverage
among low-income adults increases health care use, improves health
and well-being and reduces the financial strain for people with the
publicly funded health coverage, according to new research.
"This study shows that Medicaid substantially expands access to and use of care for low-income adults relative to being uninsured," co-principal investigator Katherine Baicker, professor of health economics at Harvard School of Public Health, said in a Harvard news release.
She and her colleagues looked at 10,000 low-income, uninsured
adults in Oregon who were randomly selected in a 2008 state lottery
to accept additional people into its Medicaid program. The health
outcomes of these people were compared to the 80,000 applicants who
weren't selected in the lottery.
The first year of the ongoing study showed that Medicaid
coverage increases the likelihood of outpatient care by 35 percent,
the use of prescription drugs by 15 percent, and of hospital
admission by 30 percent. This leads to about a 25 percent increase
in annual health care spending.
Medicaid coverage also increases the use of recommended
preventive care such as mammograms by 60 percent and cholesterol
monitoring by 20 percent. It also increases access to care. For
example, people with Medicaid were 70 percent more likely than
those without insurance to have a regular doctor's office or clinic
for primary care, and were 55 percent more likely to have a
particular doctor that they usually see.
Compared to uninsured people, those with Medicaid coverage were
40 percent less likely to have to borrow money or skip paying other
bills to pay for health care, and 25 percent less likely to have an
unpaid medical bill sent to a collection agency.
The researchers also found that the adults with Medicaid
coverage were 25 percent more likely to report they were in good to
excellent health, and 10 percent less likely to report being
The findings are published July 7 as a working paper (number
17190) on the website of the National Bureau of Economic Research.
Support for the study was provided by the U.S. National Institute
on Aging, the Centers for Medicare & Medicaid Services, the
California Healthcare Foundation, and other foundations and
"Some people wonder whether Medicaid coverage has any effect. The study findings make clear that it does. People reported that their physical and mental health were substantially better after a year of insurance coverage, and they were much less likely to have to borrow money or go into debt to pay for their care," co-principal investigator Amy Finkelstein, a professor of economics at MIT, said in the news release.
The researchers will follow the lottery participants for another
year and directly measure health outcomes such as obesity, blood
pressure, cholesterol and blood sugar control.
Under the Obama administration's Affordable Care Act, Medicaid
coverage will be expanded to cover additional low-income adults in
all states in 2014.
The U.S. Centers for Medicare and Medicaid Services has more
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