The authors of an accompanying editorial offered a possible explanation. Richard Kronick, of the Office of the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services, and Dr. Andrew Bindman, at the University of California, San Francisco, said Medicaid's minimal effects on physical health "are not entirely surprising given the many steps that are needed between the availability of insurance coverage and the delivery of appropriate care."
What's more, they said, the short follow-up period and small number of people with chronic conditions in the study sample may have skewed the results.
It is also possible, Meltzer said, that small improvements did occur but didn't show up as statistically significant. "A [slight] decline in blood pressure could be really important, and we can't say that didn't happen," he said.
Lessons learned from the Oregon experience could be instructive as half of the states in the nation proceed with plans to broaden Medicaid enrollment in 2014, while others remain opposed or undecided.
Results of this study and findings from earlier research on the Oregon experiment should dispel any notion that expanding Medicaid will save money, Baicker said, because "the program costs money; people consume more health care." On the other hand, the results demonstrate clear benefits to the people who are enrolled.
"Policymakers have to weigh how much they value those benefits to enrollees against alternative uses of the resources that go into the program," she said.
Go to Medicaid.gov to learn more about your state's Medicaid program.
SOURCES: Katherine Baicker, Ph.D., professor of health economics, Department of Health Policy and Management, Harvard School of Public He
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