Latest study

Medicaid improves users’ mental health

By Ricardo Alonso-Zaldivar

WASHINGTON — If you’re uninsured, getting on Medicaid clearly improves your mental health, but it doesn’t quickly make much difference in physical conditions such as high blood pressure.

The counterintuitive findings by researchers at Harvard and MIT, from a two-year study of low-income Oregonians, appear in today’s New England Journal of Medicine. The study offers a twist for states weighing a major Medicaid expansion under President Barack Obama’s health-care law that would serve a similar population of adults around the country.

“The study did not generate any evidence that Medicaid coverage translated to measurable improvements in physical-health outcomes,” said lead researcher Katherine Baicker of the Harvard School of Public Health. “It did generate robust improvements in mental health and enormous reductions in financial strain and hardship.”

It also debunks the idea that having Medicaid is no better than being uninsured. A federal-state partnership, Medicaid covers more than 55 million low-income and severely disabled people.

Obama’s health-care law envisioned expanding Medicaid to anyone making up to 138 percent of the federal poverty line, or nearly $15,860 for an individual. About 15 million people could eventually be covered if all states accepted the expansion. But the Supreme Court last year gave states the right to reject the expansion.

The study found that having Medicaid reduced rates of depression by 30 percent and virtually eliminated catastrophic medical expenses. People with Medicaid had better access to doctors, preventive care, prescriptions and hospitals. They also used their benefits, consuming about $1,200 a year more per person in health-care services than do the uninsured.

But Medicaid had no significant effect on blood-pressure readings, high cholesterol or elevated blood-sugar levels, although it did increase the probability that people with diabetes would be diagnosed.

Obama administration officials, in a statement published with the study, suggested that two years might not be enough time for health to improve, particularly for patients with chronic conditions influenced by lifestyle choices.

Expanded Medicaid will be available starting Jan. 1, and uninsured people can start signing up this fall. So far, 21 states plus Washington, D.C., have accepted the expansion, while 14 states have turned it down. Fifteen other states, including Ohio, still are weighing their options.