Medicaid’s Health Outcomes Put a Damper on Falling Uninsured Rate

Posted: Sep 17, 2014 12:01 AM

Despite the millions of families who have had their health plans cancelled, can’t see their own doctor, and are paying more, but getting less, some people are still finding ways to celebrate Obamacare.

The latest touchdown dances cite a drop in the percentage of people who are uninsured, primarily in states that expanded Medicaid under the Affordable Care Act. Similarly, defenders of the law are also chastising states that refuse to expand Medicaid, blaming them for keeping the joys of Obamacare out reach for their residents.

Indeed, Gallup reported that states which expanded Medicaid under the Affordable Care Act saw the biggest drops in their uninsured population. On the flip side, the Urban Institute, a liberal think tank, reported that most of the remaining uninsured population resides in non-expansion states. Game, set match, right? Not exactly. A closer look at Medicaid reveals that the sentiments from Obamacare proponents are deeply unsound. No advocate of truly constructive health care reform should be celebrating newly insuring millions more people onto this failed welfare program. Unfortunately, that is exactly the case with several million of Obamacare’s “success stories.”

Medicaid, like many government programs, does a poor job when it comes to results. The outcomes it delivers – for nearly $500 billion dollars a year – are shockingly poor. Manhattan Institute Senior Fellow Avik Roy went so far as to call it “a humanitarian catastrophe…the greatest scandal in America.” To make health care reform so heavily dependent on a program like Medicaid was not only misguided, it was downright irresponsible. Medicaid was riddled with problems long before the Affordable Care Act was thrust upon the American people, and Obamacare’s Medicaid expansion will only make these problems worse.

A closer look at Medicaid reveals the simple truth that putting an insurance card in every person’s pocket by no means guarantees improved health outcomes. After all, what good is an insurance card if the doctor won’t take it, or if the care it gets patients is no good at all?

In many major cities, less than half of all doctors accept Medicaid, mostly because of the low reimbursement rates and the bureaucratic headaches associated with the program. When they do, health outcomes are often so bad, patients may actually be better off uninsured. As Roy spelled out in Forbes, mortality rates for a number of illnesses are higher among Medicaid patients than even those who are uninsured.

Access to care and resulting health outcomes under Medicaid were unacceptably poor before Obamacare. Expansion adds millions of people onto Medicaid but adds no new doctors. What can be expected to happen to access and quality with this new influx?

Worst, Medicaid was originally intended to insure truly vulnerable populations living at or below the poverty line. But according to the Urban Institute, over 80 percent of the expansion population consists of able-bodied, childless, working-age adults. Medicaid expansion will crowd out the most vulnerable populations in order to make room for this new, less vulnerable group. And, as we are already seeing in states like Oregon and Arkansas, and even nationally, problems are beginning to mount for Medicaid patients amid expansion.

Though it may be a useful talking point for Obamacare defenders (the vast majority of whom who will never have to experience Medicaid for themselves), being among the ranks of the “newly insured” surely provides little solace for people struggling with limited access to doctors and receiving subpar care.

Proponents of government-run health care who promised “quality, affordable health care” are applauding – but an objective analysis suggests that Medicaid is neither “quality” nor “affordable” – and that is something no one should be cheering about.