June 23, 2018
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Why health insurance helps


A study released this week shows what should be obvious — people with access to health care are in better health and better off financially than those without. The study focused on Medicaid, the federal-state health care program for the poor. These results should bolster the idea that providing health insurance — at an affordable rate — to as many people as possible is a crucial piece of lowering health care costs.

The study, led by researchers from Harvard and MIT and released Thursday by the National Bureau of Economic Research, looked at 10,000 Oregonians who were able to participate in the state’s Medicaid program through an unusual lottery system. The lottery system gave researchers as opportunity to follow people who were identical, other than that some won spots in Medicaid and others didn’t. They followed the lottery winners and losers for a year — and will continue to do so, so information about longer-term results will be available later.

Those who got to enroll in Oregon’s Medicaid program were more than 50 percent more likely to have a personal doctor and were more likely to get preventative care, such as mammograms and cholesterol screening.

There have long been arguments that providing more affordable access to care will drive up medical costs because people will go to a doctor’s office or hospital more frequently. The study found that this was true. More people sought medical treatment, which cost the state and federal government more — at that time. More time is needed to see if additional preventative care saves money in the long run.

The trade-off was the security that people felt and experience as a result of having medical coverage. Sick days decreased by 15 percent and those enrolled in Medicaid were 40 percent less likely to skimp on other financial commitments. Both are important to employers and the economy in general. Less easy to quantify, but also important, is that those who were covered by Medicaid reporter being happier, likely because worrying about their health and paying for medical care was less of a concern.

These are important findings as Medicaid will be the program that covers the nation’s 30 million uninsured beginning in 2014 under the Affordable Care Act.

This doesn’t mean, of course, that Medicaid couldn’t use improvements and that work shouldn’t continue to reduce medical costs and to make health insurance more affordable. But it does show that having health insurance, including through the often maligned Medicaid program, is key to improved health and economic status.

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