NCPA - National Center for Policy Analysis

Medicaid Patients Have Worse Access and Outcomes than Privately Insured

November 12, 2012

One way the Obama administration chose to deal with the pressing health care crisis was a massive expansion of Medicaid.  Despite good intentions to help the poor, research shows that this expansion aggravates the plight of the very group it intends to help, says Kevin Dayaratna, a graduate fellow in the Center for Health Care Policy Studies at the Heritage Foundation.

Studies indicate that Medicaid patients lack access to the types of care privately insured patients enjoy, in large part because low reimbursement rate deters doctors from seeing these patients. Indeed, Medicaid usually pays physicians just 56 percent of the amount that private insurers pay. The expansion of Medicaid will only magnify this crisis.

  • A 2001 study published in the Journal of Health Care for the Poor and Underserved reports that pediatric Medicaid patients were more likely to be discharged on subpar medication routines.
  • A 2003 study published in the Archives of Internal Medicine that compares health outcomes for colorectal, lung, prostate and breast cancer in Kentucky for a variety of insurance classifications also found similar results. For all four illnesses, the survival rates are markedly higher for privately insured patients than for Medicaid patients.
  • A 2010 study in the Journal of Hospital Medicine found similar results for non-cancer-related illness. Even after adjusting for factors such as age, gender, income, other illnesses and severity, Medicaid patients had higher in-hospital mortality rates.
  • A 2012 study in Health Affairs examined physicians' willingness to accept new patients. It found that nearly one-third of physicians nationwide will not accept new Medicaid patients.

In short, Medicaid not only hampers access to care, but it also fails to meet patients' needs.

Dayaratna says Congress should consider the following:

First, repeal the Affordable Care Act and its Medicaid expansion. This expansion will only flood millions of patients into a broken system.

Second, maximize access to private health insurance for Medicaid beneficiaries.

  • Florida has pursued this path by giving Medicaid patients a choice of private managed care plans.
  • A five-county pilot version of the program flattened Medicaid costs and was saving the state slightly under $120 million annually.
  • Additionally, the program noted greater access to care, higher degrees of patient satisfaction, and a marked improvement in health outcomes.

Source: Kevin Dayaratna, "Studies Show: Medicaid Patients Have Worse Access and Outcomes than Privately Insured," Heritage Foundation, November 7, 2012.


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