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Medicaid has mixed records on healthcare

By Ricardo Alonso-Zaldivar

Associated Press

Published: Thursday, May 2 2013 6:25 a.m. MDT

Dr. Ileana Fuentes, left, examines Ashley Jeannithe, 3, at the Borinquen Health Care Center, Monday, April 15, 2013, in Miami. Jeannithe, who is uninsured, was visiting the clinic with her mother for a routine check-up.

Lynne Sladky, Associated Press

Enlarge photo»

WASHINGTON — If you're uninsured, getting on Medicaid clearly improves your mental health, but it doesn't seem to make much difference in physical conditions such as high blood pressure.

The counterintuitive findings by researchers at Harvard and MIT, from an experiment involving low-income, able-bodied Oregonians, appear in Thursday's New England Journal of Medicine. The study offers a twist for states weighing a major Medicaid expansion under President Barack Obama's health care law, to serve a similar population of adults around the country.

"The study did not generate any evidence that Medicaid coverage translated to measurable improvements in physical health outcomes over a two-year window," said lead researcher Katherine Baicker of the Harvard School of Public Health. "It did generate robust improvements in mental health and enormous reductions in financial strain and hardship."

That leaves policymakers with "a much more nuanced and complex picture" of the potential benefits of expanding Medicaid, said Baicker, an economist.

Obama's health care law envisioned expanding Medicaid to anyone making up to 138 percent of the federal poverty line, or nearly $15,860 for an individual. About 15 million people — mostly adults with no children living at home — could eventually be covered if all states expand. But last year the Supreme Court gave states the right to reject the expansion without jeopardizing the rest of their federal Medicaid funds.

The study found that having Medicaid reduced rates of depression by 30 percent and virtually eliminated catastrophic medical expenses due to a serious accident or the sudden onset of a life-threatening illness.

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