The ongoing debate about the positive impact of Medicaid coverage has one more piece of evidence in its corner, as the second part of the Oregon Health Study was released today, finding that Medicaid “substantially improves the well-being of beneficiaries.”
Back in 2008, an unprecedented opportunity arose as Oregon held a lottery for open slots in its Medicaid program, allowing researchers to examine the impact of having Medicaid on a group of randomly selected individuals – the gold standard of research that had previously been unattainable.
The findings are consistent with the preliminary Oregon Study results released in 2011 and show that Medicaid coverage increased overall health care utilization, including the use of certain preventive and screening services and prescription drugs. It also reduced the financial burden on enrollees, in particular by almost completely eliminating catastrophic out-of-pocket expenses.
The study found that securing Medicaid reduced rates of depression by 30% and increased self-reported mental health. It was also shown to improve self-reported health, although the results did not find marked improvement in physical health over the two-year window as rates of hypertension and high cholesterol did not change. Despite the fact that enrollees were more likely to be diagnosed with diabetes and use medication for its treatment, there was no significant improvement in controlling their blood sugar levels.
As the authors state in the article “although changes in health status are of great interest, they are not the only important potential benefit of expanded health insurance coverage.” Insurance is, after all, a financial product, designed to provide security against health expenses, especially those unexpected like an injury or illness. Economic security is an objective that all Americans share in obtaining health insurance – and for those who are most insecure amongst us – the study finds that Medicaid fulfills that role incredibly well.
As for the health benefits, there are several possible explanations as to why they might not have materialized. The study period was just two years and the average length of coverage was just 17 months. It’s reasonable to think that this might not be enough time for the changes to appear – especially for chronic conditions that are highly influenced by lifestyle choices. It’s also possible that the limited number of patients with these conditions may make it hard to detect changes in health.
No doubt opponents of extending Medicaid coverage will use this study to suggest that it is not worth it; yet a close reading suggests otherwise. While we need to wait for more evidence on the implications for physical health, it’s clear that the mental health and financial stability benefits that the program provides leave those with Medicaid far better off. And for those who recently voted against legislation to institute background checks for purchases of guns on the theory that mental health problems – not guns – were the cause of recent mass shootings – shouldn’t this study inspire them to urge states to accept federal Medicaid dollars and move forward with coverage?