Columnist Jeff Sadow makes two basic claims in support of Gov. Bobby Jindal’s decision to turn his back on more than 300,000 working-age Louisiana adults who could benefit from Medicaid expansion: First, he says expansion costs the state too much. Second, he claims that having Medicaid coverage is no better than being uninsured — and that people might actually be better off without insurance than on Medicaid. Both claims are false.
Let’s start with cost: Sadow relies on an outdated estimate from the Jindal administration. But 28 states and the District of Columbia have now taken advantage of the chance to expand coverage using federal dollars, and many are actually saving money as a result. How is that? Those states, including our neighbor Arkansas, are using federal dollars to increase access to primary care doctors and clinics while reducing state spending on inefficient and outdated charity care programs.
Next, Sadow claims that people without health insurance actually fare better than people on Medicaid. To prove his point, he cites a famous study in Oregon, which compared the experience of two groups of uninsured adults — one that received Medicaid coverage and another that remained uninsured.
Here is what the Oregon study actually found: Adults with Medicaid were more likely to have a primary care doctor and get treatment for chronic conditions like diabetes. They were 25 percent more likely to report themselves in “good” or “excellent” health and 25 percent less likely to have an unpaid medical bill sent to a collections agency. People with Medicaid coverage were 30 percent less likely to experience depression and much more likely to be monitoring their cholesterol and receiving routine mammograms.
While it’s true that Medicaid recipients used health care services more frequently than the uninsured, this is not a bad thing. It tells us that those who don’t have coverage avoid seeking care even when it’s needed.
Most importantly, another study in the New England Journal of Medicine found that Medicaid expansion reduces mortality rates. It saves lives. I can’t think of a better health indicator than life or death.
Rather than expand coverage, Sadow advocates sticking with the health care status quo. But that simply isn’t good enough. Here in Baton Rouge, the closure of Baton Rouge General’s mid-city emergency room shows what can happen when hospitals struggle under the financial weight of uninsured patients. In states that expanded Medicaid, uncompensated care is down, and hospitals and doctors are getting paid for seeing patients. And that is good for everyone, because you can’t get care at your local hospital if it is forced to shut its doors.
director, Louisiana Budget Project