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Study: Medicaid increases use of health care, decreases financial strain, improves health

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Researchers have found that expanding low-income adults’ access to Medicaid can lead to increases in health care use, reductions in financial strain on covered individuals and an improvement in self-reported health and well-being. The study was released as a working paper on the website of the National Bureau of Economic Research.

“This study shows that Medicaid substantially expands access to and use of care for low-income adults relative to being uninsured,” study author Katherine Baicker stated in a Harvard School of Public Health release.

In 2008, Oregon held a lottery to accept additional low-income, uninsured residents into its Medicaid program. Ten thousand of the 90,000 individuals who applied were accepted, with researchers collecting data on the lottery participants from hospital records and mail surveys. Outcomes were then compared between those who had been selected by the lottery and those who had not been selected — allowing the researchers to determine the impact of Medicaid.

Though the study is ongoing, the authors reported that some of the key findings in the first year include:

• Medicaid coverage increases the likelihood of outpatient care use by 35%, prescription drug use by 15% and hospital admission by 30%, resulting in a 25% increase in annual health care spending;
• coverage increases the probability individuals report having a regular primary care office or clinic by 70%;
• coverage decreases the probability of having an unpaid medical bill sent to a collection agency by 25%; and
• coverage increases the probability that individuals report themselves in good to excellent health by 25%.

The current study is part of a broader research program that will follow the lottery participants for an additional year, directly measuring health outcomes such as cholesterol, diabetic blood sugar control, blood pressure and obesity.

Reference:

• Finkelstein A, Taubman S, Wright B, et al. The Oregon health insurance experiment: Evidence from the first year. NBER Working Paper No. 17190. Issued July 2011.
• www.nber.org

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