Senior Research Analyst
Medicaid critics and some media reports have repeated claims that Medicaid coverage is harmful and beneficiaries would be better off being uninsured. They base them on a misunderstanding or misleading use of research that finds poor health outcomes among Medicaid enrollees. But studies that are designed to specifically evaluate Medicaid’s causal effects overwhelmingly find that the program produces health and financial benefits for participants.
The studies that critics cite weren’t designed to test the causal relationship between Medicaid and health outcomes. A New England Journal of Medicine (NEJM) article from leading health economists summarizes these studies’ serious limitations. The studies:
In contrast, a wide body of research has specifically tested Medicaid’s effects on beneficiaries’ health and financial well-being. These studies take advantage of the variation in state Medicaid eligibility levels to deliberately test causation between Medicaid and health outcomes. They consistently find that Medicaid results in better health outcomes than the uninsured have, as health economist Austin Frakt points out in NEJM.
Most recently, research in Oregon on Medicaid coverage for a limited group of adults has allowed for the gold standard of a randomized control study experiment. The state used a lottery to decide which low-income uninsured adults on a waiting list for Medicaid could apply for coverage. The lottery thus allowed researchers to compare two groups of people who differed in only one major way: one group got Medicaid coverage and the other did not. That research has found that Medicaid, as expected, substantially improves patients’ health and provides financial protection against unaffordable out-of-pocket costs.
As Medicaid turns 50, learn more about how it improves access to health care, its long-term benefits, and why states should expand Medicaid: www.cbpp.org/medicaid-at-50.