Medicaid Effect

Wealth, not health protection

Medicaid, the health program for disabled and low-income individuals, might not actually make people healthier, according to a study published in May. A team of health researchers led by Katherine Baicker and Amy Finkelstein of the Massachusetts Institute of Technology used a lottery to randomly select thousands of low-income individuals in Oregon to receive Medicaid. That group was compared with a randomly selected control group who didn’t get the program. 

The researchers found that the Medicaid beneficiaries used far more health services, at far greater cost, than those not selected for the program. They were also significantly less likely to screen positive for depression, and they faced fewer health-related financial shocks than their counterparts in the control group. The Medicaid beneficiaries also reported that they felt healthier.

But it may have been only a feeling. The self-reported improvement in health status didn’t match the objective physical health measures the study’s investigators tracked. Indeed, Medicaid beneficiaries appeared to be no healthier, on average, than the cohort who did not receive the benefit. Over the two years the study was conducted, the authors found that “Medicaid coverage generated no significant improvements in measured physical health outcomes.” 

Preliminary results published in July 2011 suggested as much: Those results did not report on objective health measures, but they did find that two-thirds of the improvement in self-reported health came prior to the provision of any medical care. 

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