With health care reform still up for debate, some policymakers continue to question whether Medicaid coverage actually improves access to care, quality of care, or financial protection. As the number of Americans insured by Medicaid climbs to over 70 million, including an estimated 12 million who gained access through the Affordable Care Act, it’s a claim worth examining.
A new report from the non-partisan Commonwealth Fund set out to evaluate the claim by analyzing the results of the 2016 Commonwealth Fund Bienniel Health Insurance Survey. The study found that Medicaid patients report similar experiences as the privately insured and significantly better than the uninsured.
The study compared the experience of working-age adults who were either covered all year by private employer or individual insurance, covered by Medicaid for the full year or uninsured for some time during the year. Here are the highlights:
Medicaid Enrollees Report Better Care Experiences Than the Uninsured and Similar Experiences as the Privately Insured
When asked about access to health services and perceived quality of care, Medicaid enrollees were just as likely as the privately insured and significantly more likely than the uninsured, to report having a regular source of care, among adults insured all year. Medicaid enrollees and privately insured adults both rated their care highly and significantly higher than uninsured adults. Medicaid enrollees reported slightly lower rates for getting a same day appointment as privately insured adults and slightly higher than uninsured patients, but neither was statistically significant.
Medicaid enrollees receive preventive services at higher rates than people who are uninsured
Adult survey respondents with uninterrupted Medicaid coverage were significantly more likely to report having preventive services like cholesterol checks, flu shots, Pap tests, mammography, and colon cancer screenings. There were no significant differences between adults with private coverage and Medicaid beneficiaries in rates of preventive care with one exception: 83 percent of privately insured adults reported having had their cholesterol checked, compared with 74 percent of adults with Medicaid.
Medicaid enrollees had fewer problems paying medical bills and fewer cost-related access problems than the privately insured and the uninsured
In a significant finding of the study, when asked whether they had problems paying medical bills or getting necessary health care services related to cost, respondents with Medicaid coverage were significantly less likely than either privately insured or uninsured individuals to report having difficulty paying medical bills within the past year, having to change their way of life to pay medical bills, or to be paying off medical debt over time.
Those with Medicaid were also significantly less likely to cite cost of care as a reason for skipping needed services in the past year than adults who were privately insured or uninsured. In some cases, differences between adults with Medicaid coverage and those who were privately insured were statistically significant and the gaps were sometimes substantial. For example, privately insured adults reported skipping a recommended medical treatment, test, or follow-up visit because of the cost at rates more than twice as high as those for Medicaid enrollees (17 vs. 7 percent).
The original version of this article ran on The Commonwealth Fund website on April 27, 2017.