Medicaid fails to improve health for uninsured

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WASHINGTON (AP) — 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 today’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.

It also debunks a widespread perception that having Medicaid is no better, and maybe even worse, than being uninsured. A federal-state partnership, Medicaid covers more than 55 million low-income and severely disabled people, ranging from poor children to nursing home residents. It pays providers less than Medicare or private insurance.

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 the Supreme Court last year 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. People with Medicaid had better access to doctors, preventive care, prescriptions and hospitals. They also used their benefits, consuming about $1,200 a year more per person in health care services than do the uninsured.

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