A newly published Commonwealth Fund study sheds light on the health care experiences of Medicaid enrollees when compared with privately insured and uninsured individuals. Accessibility and quality outcomes for Medicaid enrollees have long been subjects of heated debate. Proponents of Medicaid expansion note that access to and use of health care services – particularly preventive care – through Medicaid reduces emergency department utilization and the cost to hospitals of uncompensated care. The Trump Administration recently reversed an Obama Administration policy of withholding federal funds to states to fill in financial holes for hospitals’ uncompensated care costs, which was meant to encourage states to expand Medicaid. This policy reversal comes in spite of evidence that Medicaid expansion has significantly reduced uncompensated care costs and improved hospitals’ financial stability. These arguments also ignore the fact that Medicaid provides access to comprehensive health care services for vulnerable populations including children, the elderly, and the disabled. Medicaid also provides critical services such as maternal care, mental health and substance use disorder services, and long-term services and supports like nursing home care.
The results of the Commonwealth study demonstrate the value of the Medicaid program from an access standpoint. This study surveyed adults with Medicaid for the full year, adults with private insurance for the full year, and adults with no coverage either at the time of the survey or at some point in the past year. The study found that Medicaid enrollees generally have access to care at rates comparable to those experienced by the privately insured population. Medicaid enrollees reported better care experiences than those without insurance and similar experiences to those with private insurance. Medicaid enrollees also received preventive care at a rate similar to that of individuals with private insurance and at a much higher rate than those without insurance. Medicaid enrollees also had fewer issues paying medical bills and had fewer instances of cost-related access issues than both the privately insured and uninsured populations.
The results of this study demonstrate that Medicaid provides access to crucial health care coverage for low-income and vulnerable populations. This is yet another piece of evidence that Medicaid expansion has moved the U.S. health care system toward achieving the American Nurses’ Association’s principles for health care reform: universal access to a standard package of essential health benefits for all citizens and residents; utilization of primary, community-based and preventative services while supporting the cost-effective use of innovative, technology-driven, acute, hospital-based services; the economical use of health care services with support for those who do not have the means to share in costs; and a sufficient supply of a skilled workforce dedicated to providing high quality health care services.