Compared with the uninsured adults, the Medicaid adults were 25% more likely to report they were in good to excellent health (versus fair to poor health), 40% less likely to report health declines in the last six months, and 10% more likely to screen negative for depression.
One year out from the lottery, the adults who gained Medicaid were 70% more likely to have a regular place of care and 55% more likely to have a regular doctor than the adults who did not gain coverage.
Thus, the adult populations studied in most Medicaid research are extremely poor. Because of Medicaid’s eligibility criteria and the strong correlation between poverty and poor health and disability, Medicaid beneficiaries are poorer and have a poorer health profile compared with both the privately insured and the uninsured.
Gains in physical health were more limited: while Medicaid did increase the detection of diabetes and use of diabetes medication, it did not have a statistically significant effect on diabetes control, or on control of high blood pressure or high cholesterol.
Compared with the uninsured adults, the Medicaid adults were 25% more likely to report they were in good to excellent health (versus fair to poor health), 40% less likely to report health declines in the last six months, and 10% more likely to screen negative for depression.
Medicaid was designed to provide health coverage for low-income children and families who lack access to private health insurance because of their limited finances, health status, and/or severe physical, mental health, intellectual, or developmental disabilities.
Because all Medicaid MCO enrollees are insured but a large share of health center patients are uninsured, MCO performance is a demanding benchmark to use for health centers. The study produced the following key findings: More than 1 in 10 health centers have consistently high performance relative to Medicaid MCOs.
Two rounds of findings have been published in the New England Journal of Medicine, which can be summarized, in part, as follows: Medicaid increased access to care and health care use, and improved self-reported health.
Second, health insurance lowers financial barriers to access. It does this by reducing out-of-pocket costs for medical care, which disproportionately burden low-income people and people with extensive health care needs.
Compared with both privately insured people and the uninsured, Medicaid beneficiaries have much higher rates of ED use. 43 However, a substantial body of research investigating this disparity more closely indicates that poorer health and access challenges in Medicaid both play important roles in explaining Medicaid’s higher ED visit rates.
In its totality, the research on Medicaid shows that the Medicaid program, while not perfect , is highly effective . A large body of studies over several decades provides consistent, strong evidence that Medicaid coverage lowers financial barriers to access for low-income uninsured people and increases their likelihood of having a usual source of care, translating into increased use of preventive, primary, and other care, and improvement in some measures of health. Furthermore, despite the poorer health and the socioeconomic disadvantages of the low-income population it serves, Medicaid has been shown to meet demanding benchmarks on important measures of access, utilization, and quality of care. This evidence provides a solid empirical foundation for the ACA expansion of Medicaid eligibility to millions of currently uninsured adults, and individuals and communities affected by the Medicaid expansion can be expected to benefit significantly. At the same time, the Medicaid program cannot overcome health care system-wide problems, like gaps in the supply and distribution of the health care workforce, or lack of access to transportation in low-income communities. Nor can Medicaid be expected to tackle many other barriers and issues that disproportionately affect low-income individuals and communities. These challenges require an additional set of policy responses beyond Medicaid’s ambit.