The OLC has previously reported on the “Oregon Experiment,” which began in 2008 with a group of uninsured, low-income adults who were given the opportunity to participate in a lottery to apply for Medicaid benefits. Researchers followed the group that won the lottery as well as the group who remained uninsured to determine what benefits, if any, were had by placing more individuals on Medicaid.
In May 2013, a study on the Oregon Experiment was published in the New England Journal of Medicine. The study found that there were “no significant improvements in measured physical health outcomes” for Medicaid patients as compared to uninsured patients.
Despite these findings and other problematic results of Medicaid expansions in Maine and Arizona, the Kasich administration bullheadedly went forward with Obamacare’s Medicaid expansion in Ohio.
In January of this year, a new study on the Oregon Experiment was published in Science Magazine, which looked at emergency room usage. Ohioans may recall the Kasich administration’s assurance that Medicaid expansion would lead to lower use of the emergency room , especially for issues that could be handled through scheduled office visits.
Well, lo and behold, the study’s authors found that Medicaid expansion recipients used the emergency room 40% more than the uninsured group. What’s more, a majority of the emergency room visits by expansion patients were unnecessary.
A little dose of common sense leads one to the same conclusion without all the bells and whistles of a scientific study. With Medicaid requiring only minimal co-pays, if any at all, there is no incentive for recipients to seek a primary care provider over an emergency room. And with a significant number of office based doctors (28% here in Ohio) refusing to see Medicaid patients, why bother calling around to secure an office appointment when it is just as cheap to go to the ER?
Time will tell how Obamacare’s Medicaid expansion will affect ER usage in Ohio, but with Medicaid expansions in Maine, Arizona, and Massachusetts also experiencing increased ER usage, why should we expect a different outcome here? It’s hard to believe that there is something about the constitution of a Buckeye which leads them to act differently than Medicaid recipients in other states.
Public policy and the economics behind it doesn’t have to be that difficult if one considers human nature. What is difficult is finding a politician willing to choose common sense and scientifically measured results over federal dollars. Here in Ohio, we are still looking for such a leader.