One of the key arguments that opponents of expanding Medicaid make is that there is no point in doing so because access is so poor in Medicaid that it won’t actually help the intended beneficiaries get the care they need.

There is certainly room for improvement in access to care for Medicaid beneficiaries, and it will be especially important to monitor access barriers as millions more individuals enroll in Medicaid. However, that is no reason to oppose further expansion of the program. Using access as an excuse not to extend Medicaid to more people is misguided for a number of reasons.

First, and often overlooked in the Medicaid debate, is the fact that Medicaid is an insurance program that provides protection from medical debt and bankruptcy that other adequately insured Americans enjoy. And it is virtually indisputable that Medicaid reduces access barriers that are attributable to cost – often better than private insurance does. For those lowest income Americans who remain in the coverage gap, the economic security that comes from having insurance is an unmitigated benefit.

Second, opponents of Medicaid expansion often paint a much more dire picture of access than research reveals. Many studies show that Medicaid enrollees prior to expansion in general have access to care at similar rates as those in employer-sponsored insurance. As the authors of one study published in 2013 by the Kaiser Family Foundation stated “Consistent with previous research, our analysis underscores how Medicaid coverage facilitates access to care for program beneficiaries. We find that Medicaid provides access to health care services comparable to that of ESI but at significantly lower costs.”

But opponents might convincingly argue that we must look at research conducted post 2014 when millions more people joined the program. While we will have to wait for more studies to emerge on this important question, three recently published studies suggest that newly enrolled Medicaid beneficiaries are clearly benefitting from access to needed services post 2014.

First let’s look at a study conducted by the Commonwealth Fund entitled “Does Medicaid Make A Difference?” This study surveyed adults that had private coverage, Medicaid or were uninsured in 2014 and concludes: “Medicaid coverage provides access to care that in most aspects is comparable to private insurance.” The study also found that Medicaid enrollees rated the quality of care that they received as highly as privately insured adults and significantly better than uninsured adults.

Another study published recently in the Journal of the American Medical Association by Benjamin Sommers et al looks specifically at states that have expanded Medicaid versus those that have not. This study finds that (not surprisingly) states that have expanded Medicaid are seeing greater reductions in their rate of uninsured adults, but also that low-income adults are seeing considerable gains in access to care as compared to adults in states that have not expanded. In particular, respondents reported having an easier time accessing needed medication and personal physicians as well as fewer financial barriers to care.

Finally, a study published in the journal Health Affairs looked at an interesting question raised by Michigan’s Medicaid expansion. Michigan expanded its Medicaid program using Section 1115 waiver authority and requires all new enrollees to see a primary care provider within 60-90 days of enrollment. Michigan has seen very robust enrollment in its expansion population – the authors note that approximately 350,000 Michigan residents enrolled during the 6-month study period in 2014 immediately after eligibility commenced.

Using a “secret shopper” approach, researchers called providers both before and after expansion posing as a new Medicaid patient to see if they could make an appointment. The study found that the availability of appointments actually increased by 6% after expansion despite the large influx of new enrollees. Wait times for appointments remained essentially unchanged before and after expansion.

Overall, the latest research reinforces previous findings that show that gaining Medicaid coverage means people have an easier time seeing a doctor when they are sick and getting the medicine and treatment they need to get better. Thus, the issue is not whether expanding Medicaid will benefit those living in poverty but rather will the minority of states that have not yet expanded coverage find a way to move forward and extend Medicaid. Access concerns should be carefully monitored and those concerns can and should be addressed. But they are no excuse to deny health care coverage to Americans with the lowest incomes.