The Difference Medicaid Makes

With the House scheduled to vote Wednesday on repealing health reform, and some governors vowing not to move forward with the law’s expansion of Medicaid to cover low-income adults, this is a good time to remind ourselves why Medicaid coverage is so beneficial.

A landmark, ongoing study of Oregon’s Medicaid program does just that, as the New York Times recently explained.

In 2008, Oregon held a lottery to decide which low-income, uninsured adults on the state’s waiting list for Medicaid could apply for coverage.  An all-star group of researchers has been studying what happened to those who got coverage and those who didn’t.

This sort of random assignment — comparing two groups of people who differ in only one major way — is the gold standard for scientific research.  But it is extremely unusual in social policy research, since it is unethical to deny people something like health care just for the sake of an experiment.

As we reported earlier, the researchers have found that the people with Medicaid were, among other things:

• More likely to receive doctor-recommended preventive care (for example, women were 60 percent more likely to have a mammogram);

• 70 percent more likely to have a regular office or clinic where they could receive primary care;

• 40 percent less likely to have to borrow money or leave other bills unpaid in order to cover medical expenses; and

• 40 percent less likely to experience a decline in their health over the last six months.

Interviews by the New York Times put faces on these numbers and show how Medicaid benefited people in the study.  For example:

• John Bell had filed for bankruptcy because he was unable to pay a $6,000 medical bill for emergency surgery.  Now with Medicaid, he has a doctor who is helping him improve his diet to help control his diabetes.  “I feel like a different person,” he says.

• Wendy Parris suffered for four years after shattering her ankle and was unable to get adequate care because she lacked insurance.  Since obtaining Medicaid, she has had ankle surgery and is far more mobile.  “It saved my life,” she said.

The picture is very different for those who remain uninsured:

• Samantha Kious was diagnosed with Stage 2 cervical cancer, which remains untreated.  “It’s scary for me, having cancer and knowing I can’t do anything about it,” she said

• Christine Toman suffers from a chronic pulmonary condition and hepatitis C.  She said she goes to the emergency room when her conditions worsen but otherwise goes without care.  She said, “I went to work.  I paid my bills.  And now I feel like a hopeless, hopeless old woman that’s in the way, and it’s sad to feel like that.  I’d like to die with some pride.”