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InsiderOnline Blog: May 2013

Putting People on Medicaid Doesn’t Improve Their Health

Researchers from Harvard and MIT have found that being on Medicaid makes no noticeable difference in objective measures of health such as blood pressure, blood sugar, and cholesterol levels. The findings, which come from studying low-income Oregonians, have just been published in the New England Journal of Medicine. Expanding Medicaid, you may recall, is a big part of what ObamaCare does.

Two years ago, Oregon expanded Medicaid eligibility, but didn’t have enough money to cover everyone who enrolled. So the state conducted a lottery to decide who got coverage and who didn’t. That decision essentially produced a natural experiment in Medicaid coverage. The Harvard/MIT team conducted a randomized controlled trial to see whether Medicaid improved health. The researchers’ bombshell conclusion: “The study did not generate any evidence that Medicaid coverage translated to measurable improvements in physical health outcomes over a two-year window.”

Some details from Megan McArdle:

No statistically significant treatment effect on any objective measure: not blood pressure. Not glycated hemoglobin. Not cholesterol. There was, on the other hand, a substantial decrease in reported depression. […]

There’s been a bit of revisionist history going on recently about what, exactly, its supporters were expecting from Obamacare—apparently we always knew it wasn’t going to “bend the cost curve”, or lower health insurance premiums, or necessarily even reduce the deficit, and now it appears that we also weren’t expecting it to produce large, measurable improvements in blood pressure, diabetes, or blood sugar control either. In fact, maybe what we were always expecting was a $1 trillion program to treat mild depression. […]

Either people with insurance are doing an okay job of getting treatement for all the major chronic diseases—which is startling, because as you may recall one of the main reasons that we needed Obamacare was all the poor uninsured people who can’t control their blood pressure or diabetes. Or that the treatment Medicaid patients get for their chronic diseases doesn’t do them much good.

McArdle also points out that the findings from year two of the Oregon randomized controlled trial—the only such study that has compared having Medicaid with not having any kind of coverage—were supposed to be published last summer, but for some reason weren’t. “That’s a real pity, because many voters going to the polls last November, and governors considering whether to do the Obamacare Medicaid expansion this spring, would probably have liked to have had this data sooner.” [Daily Beast, May 1]

Posted on 05/06/13 02:29 PM by Alex Adrianson

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