Medicaid Research Shows Positive Impact on Health & Financial Stability

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Screen Shot 2016-08-03 at 1.57.52 PMAt our Georgetown CCF conference last week, I had the pleasure of moderating a panel focused on the rapidly exploding research taking place around Medicaid. This research – a new study seems to come out almost every week – looks at a wide spectrum of effects from the Medicaid program. It includes documentation of not just dramatic changes state Medicaid expansion decisions have on safety net providers and health coverage, but also the longer term effects of Medicaid on children’s lives, parent financial security, state savings and more timely diagnosis of disease.

Rachel Garfield, Associate Director of the Kaiser Commission on Medicaid and the Uninsured, Jenny Kenney, Co-director of the Health Policy Center at the Urban Institute, and Judy Solomon, Vice President for Health Policy at the Center on Budget and Policy Priorities all joined me to present an overview of some of the most comprehensive and recent studies and their findings on Medicaid. While I can’t list all the studies we covered here, I had so many questions after our panel that I pulled together a two-page list of the top ones our panelists thought people should know about. These studies form the background of statements like the following:

“Multiple studies show expanding Medicaid means not only more parents of young children get covered but also those parents are more likely to sign up their kids for health coverage too.”

“The research is clear that children on Medicaid benefit from much, much more than just better health care – over their lives they will contribute more in taxes, be more likely to attend college, will have higher wages and have longer lives.”

“Research shows parents who have Medicaid and other health coverage are more likely to see the doctor when they need to and be better able to pay medical bills – this means less stress and less hardship on children and their families.”

“The research is in on the difference Medicaid makes in life and health. Simply put, Medicaid means gains in health coverage, more primary care, and more diagnosis of chronic disease.”

“Research is starting to show how safety net hospitals and community health centers in Medicaid expansion states are outpacing their counterparts in non-expansion states by investing in providing innovative and better care to Medicaid patients.”

“Unsurprisingly, research shows that when a state Medicaid program is made more complex and confusing, fewer people enroll and remain enrolled in Medicaid health coverage.”

Below is a list of some of the main studies supporting the above statements. You can also get this studies list in a two-page PDF document:

[Comprehensive review of 61 studies comparing Medicaid expansion and non-expansion states finding dramatic differences based on state Medicaid expansion decisions.] The Effects of Medicaid Expansion under the ACA: Findings from a Literature Review, Larisa Antonisse, Rachel Garfield, Robin Rudowitz, and Samantha Artiga, Kaiser Family Foundation, Jun 20, 2016. http://kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-findings-from-a-literature-review/

[Yale Economics study finding long term effects on children getting Medicaid coverage include greater tax contributions, less likely to die prematurely, more likely to attend college, and higher wages.] Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts? David W. Brow, Amanda E. Kowalski, Ithai Z. Lurie, January 2015. http://economics.yale.edu/news/yale-economics-study-finds-long-term-impacts-medicaid#sthash.KM5ISUBh.dpuf

[Medicaid means gains in insurance coverage, more primary care, hospital care and more diagnosis of certain chronic diseases.] Early Coverage, Access, Utilization, and Health Effects Associated With the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study, Laura R. Wherry, Sarah Miller, Annals of Internal Medicine, June 21, 2016. http://annals.org/article.aspx?articleID=2513980

[Editorial on the above study summarizes findings (and is not behind a paywall).] Injecting Facts Into the Heated Debates Over Medicaid Expansion, Jeffrey T. Kullgren, Annals of Internal Medicine, June 21, 2016 http://annals.org/article.aspx?articleid=2515051

[“Parents who do not have coverage are less likely than insured parents to…see doctors and dentists and are more likely to forgo care for affordability reasons and have problems paying family medical bills. Uninsured parents’ disconnection from the health care system could have adverse spillover effects for children, who may be less likely to get needed health care and more likely to experience hardships if their parents’ health or finances deteriorate.”] Uninsurance among Parents, 1997–2014: Long-Term Trends and Recent Patterns, Michael Karpman, Jason Gates, Stacey McMorrow, Genevieve M. Kenney, Urban Institute, June 27, 2016. http://www.urban.org/research/publication/uninsurance-among-parents-1997-2014-long-term-trends-and-recent-patterns

Medicaid Expansion Producing State Savings and Connecting Vulnerable Groups to Care, Jesse Cross-Call, Center on Budget and Policy Priorities, June 15, 2016. http://www.cbpp.org/research/health/medicaid-expansion-producing-state-savings-and-connecting-vulnerable-groups-to-care

Medicaid Work Requirement Would Limit Health Care Access Without Significantly Boosting Employment, Hannah Katch, Center on Budget and Policy Priorities, July 13, 2016. http://www.cbpp.org/research/health/medicaid-work-requirement-would-limit-health-care-access-without-significantly

Indiana Medicaid Waiver Evaluation Shows Why Kentucky’s Medicaid Proposal Shouldn’t Be Approved, Judith Solomon, Center on Budget and Policy Priorities, August 1, 2016. http://www.cbpp.org/research/health/indiana-medicaid-waiver-evaluation-shows-why-kentuckys-medicaid-proposal-shouldnt-be

[Medicaid expansion actually changing how hospitals and community health centers operate.] Beyond the Reduction in Uncompensated Care: Medicaid Expansion Is Having a Positive Impact on Safety Net Hospitals and Clinics, Adam Searing, Jack Hoadley, Georgetown University, Center for Children and Families, June 2016. http://ccf.georgetown.edu/ccf-resources/medicaid_expansion_positive_impact_safety_net_hospitals_clinics/

[“States that extended Medicaid coverage to more uninsured adults saw nearly double the rate of decline in uninsured children as compared to states that didn’t accept the ACA’s Medicaid option.”] Children’s Health Insurance Rates in 2014: ACA Results in Significant Improvements, J Alker, A Chester, Georgetown University, Center for Children and Families, October 2015. http://ccf.georgetown.edu/wp-content/uploads/2015/10/ACS-report-2015.pdf

[Medicaid expansion states showed hospitalizations of uninsured people with HIV falling from 13.7% to 5.5% over the study period compared to an increase from 14.5% to 15.7% in non-expansion states.] In Four ACA Expansion States, The Percentage Of Uninsured Hospitalizations For People With HIV Declined, 2012–14, F Hellinger, Health Affairs, April 2016, Vol 35, No. 4. http://content.healthaffairs.org/content/34/12/2061.abstract

[“State Medicaid expansions to cover low-income adults were significantly associated with reduced mortality as well as improved coverage, access to care, and self reported health.”] Mortality and Access to Care among Adults after State Medicaid Expansions, B Sommers, MD, PhD, K Baicker, PhD A Epstein, MD, N Engl J Med 2012;367:1025-34. http://www.nejm.org/doi/pdf/10.1056/NEJMsa1202099

[“The ACA’s first 2 open enrollment periods were associated with significantly improved trends in self-reported coverage, access to primary care and medications, affordability, and health. Low-income adults in states that expanded Medicaid reported significant gains in insurance coverage and access compared with adults in states that did not expand Medicaid.”] Changes in Self-reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act, B Sommers, MD, PhD Munira Z. Gunja, MPH; K Finegold, PhD; T Musco, BBA JAMA. 2015;314(4):366-374. doi:10.1001/jama.2015.8421. http://jama.jamanetwork.com/article.aspx?articleid=2411283

Adam Searing
Adam Searing is an Associate Professor of the Practice at the Center for Children and Families

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