If you’ve never listened to the Tradeoffs podcast, this episode would be a good place to start. It’s a 25-minute look into why so many people think the Medicaid program needs reform.
Medicaid is a government program that subsidizes health insurance, medical care, and long-term care for about 80 million people or 19 percent of the population (depending on the measurement). The federal government provides most of the funds by offering to match every dollar states spend with anywhere from one to nine federal dollars.
Host Dan Gorenstein: “For every dollar states pay for Medicaid, the feds cover something like anywhere from 50 to 90 cents of that dollar.”
Producer Ryan Levi: “Right … And Tom Scully—who ran Medicaid for President George W. Bush—says with the feds picking up such a big part of the tab, states can go wild.”
Tom Scully: “It’s not your money. You’re spending federal tax dollars. So why not expand?”
Little wonder that this year, Medicaid will spend close to $900 billion.
Unlike just about every other discussion of this issue you will find in the media, the Tradeoffs team addresses the most reliable and important study that anyone has ever conducted on Medicaid: the Oregon Health Insurance Experiment.
Ryan Levi: “In 2008, Oregon expanded its Medicaid program. And the state used a lottery to decide who was able to join, so researchers could follow the people who got on Medicaid and the people who didn’t to see what the difference was.”
Dan Gorenstein: “Right, and this is a big deal in the research world because this type of study is what’s called a randomized controlled trial, which is considered the most rigorous type of study around.”
Ryan Levi: “Right, and this is so far the only randomized study of Medicaid and its impacts. And the researchers found that people on Medicaid were more likely to get preventive care, less likely to be depressed, less likely to get hit with big medical bills and reported being in better health.… But researchers also found no differences when it came to physical health.”
Josh Archambault: “The Oregon study found that those that were on Medicaid were no different in their health outcomes than if you were uninsured.”
The hosts also include clips from Brian Blase (Paragon Health Institute) and me.
Give it a listen for crucial information about Medicaid that most coverage omits. For recommendations on how Congress should cut Medicaid spending, click here.
