The social health program Medicaid serves a vital need, providing low-income families and individuals with health coverage. But new research suggests that it may also help to educate members about their overall health. Medicaid beneficiaries have been found to make more informed decisions and better control certain chronic conditions, compared to those without coverage. In particular, they’ve displayed the ability to control their blood pressure.
For this study, the researchers focused on two groups: almost 1,500 adults with Medicaid coverage and 3,000 adults without insurance coverage. Both groups were living below the federal poverty line (FPL). This is the measure used by the Dept. of Health and Human Services (HHS) to determine if someone qualifies for federal subsidies for their insurance premiums. The researchers used data from the 1999-2012 National Health and Nutrition Examination Surveys (NHANES), which assess the health and nutritional status of U.S. adults and children.
According to Dr. Andrea Christopher, the new study’s lead author, and a fellow at Harvard Medical School,
Medicaid beneficiaries were more aware of and in control of their high blood pressure status. They were also more likely to visit their doctor at least once per year. And, they were more aware of being overweight than those without Medicaid insurance.
Insured gain mental and physical health benefits
There has been previous research conducted regarding Medicaid members’ improved health. A previous study, known as the Oregon Experiment, showed that this coverage improved mental, but not physical health. But in that state, doctors’ visits are more common; the uninsured average about five visits annually.
However, this newer study included parts of the nation in which medical visits are less frequent, such as more rural areas. And these findings showed that Medical coverage also improved physical health. “People who have Medicaid are better off and it’s not even close,” said Dr. Benjamin D. Sommers of the Harvard T. H. Chan School of Public Health and Boston’s Brigham & Women’s Hospital.
But while blood pressure control was shown to be improved, this didn’t apply to awareness or control of diabetes or high cholesterol. “Whereas high blood pressure is relatively easy to control, diabetes is much more complicated,” said Christopher. This may be due to low-income diabetics not having access to healthy foods or outlets for exercise.
“Medicaid has some limitations in its ability to truly improve access to care, including low physician reimbursement rates, and some providers do not take Medicaid patients,” Christopher said. “Some pundits point to these to say Medicaid may not be improving access and chronic disease outcomes,” but being without insurance carries even more dangers, she said.
The findings offer more evidence of the need to expand Medicaid coverage to all 50 states. Currently, 20 states have yet to expand the coverage. “The most straightforward option is for all states to expand Medicaid,” stated Sommers. “Right now if you’re not expanding Medicaid, you are making disparities worse. I think there’s a real clear public health case to be made, especially when the federal government will pay.”
