Medicaid expansion didn't improve health in Oregon: Study

By BenefitsPro


By Kathryn Mayer

Those arguing Medicaid expansion under Obamacare will result in healthier patients might want to see the results of a new study on the question.

The study, which analyzed data from thousands of low-income people in Oregon who received access to Medicaid, found that the coverage “generated no significant improvement in measured physical health outcomes.”

Come January, millions of low-income adults will gain health insurance coverage through Medicaid in one of the farthest-reaching provisions of the Patient Protection and Affordable Care Act. For months, states have been fighting over whether to expand Medicaid, with many states still deciding. At least 18 states and the District of Columbia have decided they will move forward, providing coverage to all adults with incomes below 133 percent of the federal poverty line.

Though the study found that patients who gained Medicaid coverage made more visits to doctors and hospitals and used more prescriptions, the coverage did not do anything to make them physically healthier.

Researchers used a number of measures to calculate the effect of coverage including taking blood-pressure, cholesterol and glycated hemoglobin readings.

Researchers did find two positive effects of coverage: It made patients more financially secure, and it reduced the incidence of depression.

Oregon held a lottery among low-income adults in 2008 for a limited Medicaid expansion. Of the 90,000 people who applied, 10,000 ultimately gained coverage.

This new long-term study has been called one of the most important in analyzing the effects of Medicaid. The findings, released last week in the New England Journal of Medicine, are important because they further detail how new Medicaid patients used the health care system and how their health was affected.

An earlier study of the Oregon lottery population, published in 2011, found that new Medicaid enrollees tended to self-report better health after gaining coverage.

It also found that out-of-pocket spending had decreased, but the updated research out last week found that Medicaid patients spent $1,172 more annually than those who did not gain coverage in the lottery. Additionally, Medicaid patients were significantly more likely to be diagnosed with diabetes.

Recent research from HealthPocket, a website that compares and ranks health plans, also pointed to flaws in expanding Medicaid.

Its research found that physicians across the board report low acceptance rates for Medicaid patients — and that physician assistants and nurse practitioners are unlikely to fill the gap, raising the question of whether Medicaid expansion will simply leave more Americans insured but with no one to go to for their care.

A Gallup report also signaled challenges and costs ahead for an expanded Medicaid program: The research found that Medicaid patients are in significantly worse health than those with employer-sponsored coverage.

A third of Medicaid patients are obese, while another 22 percent are being treated for depression and 24 percent are being treated for high blood pressure, according to the latest Gallup-Healthways Well Being Index. Medicaid patients are also more likely suffer from diabetes and asthma.

Originally published on BenefitsPro.com