LA Times: Medicaid has mixed record on improving health for poor, study says

By Noam N. LeveyMay 1, 2013, 2:00 p.m.


WASHINGTON — As state leaders debate whether to expand their Medicaid programs next year under President Obama’s healthcare law, new research suggests the government insurance plan for the poor has only a mixed record of improving health.

Medicaid beneficiaries are less likely than the uninsured to have catastrophic medical expenses and significantly less likely to suffer from depression, researchers at the Harvard School of Public Health and the Massachusetts Institute of Technology found.

But those on Medicaid did no better controlling their blood pressure or cholesterol levels, raising questions about the program’s ability by itself to help low-income Americans become healthier.

The lack of health gains came even though Medicaid beneficiaries went to the doctor’s office and the hospital and filled prescriptions more frequently than those without coverage.

“I think the study dispels two extreme arguments about Medicaid,” said Harvard’s Katherine Baiker, one of the study’s principal authors and a former member of PresidentGeorge W. Bush’s Council of Economic Advisors.

“Some people say this is a terrible program. Beneficiaries don’t see any improvement in health. It is a waste of resources…. That is clearly not the case. The improvements in mental health are substantial. And there are real economic protections. Medicaid very clearly improved the well-being of beneficiaries,” said Baiker, a professor of health economics.

“At the same time, the study also dispels the opposing view that this is a wonderful program that keeps people out of the hospital and that it provides all this preventive care that saves money. That is also not true.”

The study, to be published Thursday in the New England Journal of Medicine, tracked 12,000 low-income Oregonians who entered a lottery in 2008 to get into that state’s Medicaid program.


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