Current Weather
The Spy FM

Flaws And All, Medicaid Can Improve Adults’ Health

Filed by KOSU News in Health.
July 25, 2012

Among the reasons some governors say they’re considering not expanding their Medicaid programs under the Affordable Care Act is that Medicaid is, well, not a very good program.

“Medicaid is a system of inflexible mandates, one-size-fits-all requirements, and wasteful bureaucratic inefficiencies,” Texas Republican Gov. Rick Perry wrote in a letter to Health and Human Services Secretary Kathleen Sebelius, explaining why he planned to reject the federal government’s offer to pay 100 percent of the expansion cost for the first few years and 90 percent thereafter.

“Medicaid is a failed program,” Perry told Fox News. “To expand this program is not unlike adding a thousand people to the Titanic.”

But a study just published online by the New England Journal of Medicine adds to a growing body of evidence that Medicaid, in fact, does improve the health of those it covers.

The study, whose Harvard-affiliated authors include one currently advising the Obama administration and one who worked for President George W. Bush, compared three states (New York, Maine, and Arizona) that expanded Medicaid coverage to childless, non-disabled adults in recent years to three neighboring states that did not. Those adults will be the primary beneficiaries of the expansion envisioned under the Affordable Care Act.

It found that Medicaid expansions were associated with “a significant reduction in adjusted all-cause mortality,” as well as decreased rates of care being delayed due to cost, and more people reporting themselves to be in “excellent” or “very good” health.

Now if that sounds obvious, it’s not. “Prior to Oregon, we didn’t have very good data for adults” and Medicaid, lead author Benjamin Sommers told Shots.

By Oregon, he’s referring to a landmark study from last year that was able to compare adults who got Medicaid coverage through a lottery with those who didn’t. Such a randomized trial is almost unheard of in health policy research because it most cases it would be unethical. The Oregon study was facilitated by state budget considerations.

One reason critics of Medicaid have been able to maintain the debate is that some earlier studies have, indeed, found that people with Medicaid, particularly adults, sometimes had worse medical outcomes than those who didn’t.

Sommers says that should hardly come as a shock. “We know Medicaid is designed to cover the sickest of the sick” he says. “So it’s not surprising that people who have Medicaid do worse than those who don’t.”

Sommers says this new study, which includes some of the same team working on the Oregon data, complements that one. “While it’s not a randomized study,” he said, it has a larger sample (more than 68,000 people) and examines a longer period of time (five years before and after the Medicaid expansion). [Copyright 2012 National Public Radio]

Leave a Reply

5AM to 9AM Morning Edition

Morning Edition

For more than two decades, NPR's Morning Edition has prepared listeners for the day ahead with two hours of up-to-the-minute news, background analysis, commentary, and coverage of arts and sports.

Listen Live Now!

9AM to 10AM The Takeaway

The Takeaway

A fresh alternative in morning news, "The Takeaway" provides a breadth and depth of world, national and regional news coverage that is unprecedented in public media.

View the program guide!

10AM to 11PM On Point

On Point

On Point unites distinct and provocative voices with passionate discussion as it confronts the stories that are at the center of what is important in the world today. Leaving no perspective unchallenged, On Point digs past the surface and into the core of a subject, exposing each of its real world implications.

View the program guide!

Upcoming Events in your area (Submit your event today!)

Streaming audio and podcasts

Stream KOSU on your smartphone

Phone Streaming

SmartPhone listening options on this page are intended for many iPhones, Blackberries, etc. with low-cost software applications available to listen to our full-time web streams, both News on KOSU-1 and Classical on KOSU-2.

Learn more about our complete range of streaming services

We're perfecting the patient experience - Stillwater Medical Center