Last week, the Heritage Foundation published an article claiming that studies show that Medicaid patients have worse access and outcomes than the privately insured.
This is not the full story, and here’s why: The studies cited in this article fail to recognize the fact that positive health outcomes depend on more than just access to medical care. Social and economic factors disproportionately affect Medicaid patients. Medicaid patients may not have the privilege of paid medical leave, which could delay getting to the doctor when problems arise. Limited access to affordable child care and transportation are also barriers for many Medicaid patients. Plus, people who have Medicaid often enter the program with multiple chronic conditions, or severe physical or mental disabilities, that complicate the care they receive. Many of the studies cited in this article fail to account for—or even capture—all of the factors that might ultimately explain differences in health outcomes between Medicaid patients and privately insured patients.
The truth is that Medicaid provides access to good care to millions of Americans who would otherwise be uninsured. More than 58 million people rely on Medicaid for their care. These people are low-income children and adults, people with disabilities, and low-income seniors with very high health and long-term care expenses.
Private health insurance is the right health coverage for many people, but it is not the right coverage for everyone. Cutting the Medicaid program would take affordable coverage away from millions of Americans who would not otherwise be able to afford health insurance. It would either force families to take on more debt to pay for services, or forgo needed health care services altogether in favor of other basic needs, like food or heat.
Before you listen to people who say Medicaid is bad care, take a look at these facts:
People in Medicaid have better access to care. People with Medicaid are more likely to have a regular source of care than those without insurance.
People in Medicaid get the care they need when they need it. About the same number of adults in Medicaid and private insurance plans report they “usually” or “always” get the care they think they need.
People in Medicaid are healthier. Researchers in Oregon used a randomized, controlled trial to compare the effect of having Medicaid to being uninsured. Compared to people without Medicaid, those with Medicaid were more likely to report that they were in good health, and less likely to say their health had declined over the past six months.
People in Medicaid like the care they receive. People who get their health insurance through Medicaid are actually more satisfied with their plan than people who are insured through private plans. According to the 2011 Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey Chartbook, 54% of adults with Medicaid rated their health plan a 9 or 10 on a 1-10 scale (with 10 being the highest), while only 39% of adults with private insurance rated their health plan that high.
People in Medicaid are more financially secure. Medical debt is a leading cause of financial ruin in our country. In Oregon, having Medicaid meant fewer unpaid medical bills, lower out-of-pocket expenses, and a smaller likelihood that someone would have to borrow money to pay their medical bills.
The fact is that Medicaid is working for millions of Americans, and the Affordable Care Act gives states the opportunity to let Medicaid work for even more. And that’s the truth.