Weeks before the early August deadline to negotiate a deficit reduction package in Washington, and in the midst of state struggles to balance their budgets, a landmark study was released today that unequivocally demonstrates the value of the Medicaid program.
The results of The Oregon Health Insurance Experiment clearly indicate that expanding access to Medicaid “substantially increases health care use, reduces financial strain on covered individuals, and improves their self-reported health and well-being.” For a full summary of key findings and methodological highlights, please click here.
What is it that defines this study as truly groundbreaking? In short, it’s the methodology.
In the past, health economists have compared access to care and self-reported well-being across people who have insurance and the uninsured. These populations, however, tend to be different in many ways (e.g., education, employment, initial health, etc.) and teasing out the effect of health insurance alone could be challenging.
This study, however, was conducted using a randomized, controlled design-a gold standard in medical research, yet a methodology infrequently used in social policy research due to the ethics of systematically designing a study where one population is denied coverage.
However, in 2008, the state of Oregon opened up a waiting list for its Medicaid program, drawing names by lottery to fill the openings. For the first time, this random selection process allowed health economists the opportunity to study, apples-to-apples, people on the Medicaid program and people that remained uninsured. Researchers were able to really understand the implications of insurance status versus other confounding factors since the groups were divided by chance.
This is a defining study in the field of health services research, and no doubt, will be cited for years to come. More importantly, the findings are crucial for seniors in nursing homes, people with disabilities living in the community, and children who need medical care. Proposals are on the table to dramatically slash the Medicaid program, either directly or through back-door mechanisms-like spending caps and blended rates-that would shift the burden of our struggling economy to those at greatest risk.
Negotiations are happening now, at both the state and federal level. Please use the findings from this study to ramp up your advocacy efforts. Contact your elected officials, submit a letter to the editor or op-ed, draft a blog post, leverage social media, participate in a talk radio show, birddog at town hall meetings, or host your own community forum. Please help spread the word: Medicaid increases access to and use of health care, increases financial security, and improves health and well-being. Do not cut Medicaid.
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Jessica Larochelle, Field Director, Families USA