By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    UV damage to eyes
    Warning Signs of Long-Term UV Damage to Your Eyes
    December 9, 2021
    degree for healthcare job
    The Ultimate Healthcare Recruiting and Staffing Guidebook
    March 21, 2022
    medicare part d benefits
    Everything that You Need to Know About Medicare Part D
    August 15, 2022
    Latest News
    Beyond Nutrition: Everyday Foods That Support Whole-Body Health
    June 15, 2025
    The Wide-Ranging Benefits of Magnesium Supplements
    June 11, 2025
    The Best Home Remedies for Migraines
    June 5, 2025
    The Hidden Impact Of Stress On Your Body’s Alignment And Balance
    May 22, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Conservatives: The Utah Health Exchange is Not a Model
    July 23, 2011
    Medical Malpractice Reform Losing Physician Support
    November 7, 2011
    Hospitals Aim to Apply Direct Payments of Care Delivery to Increase Resources
    August 28, 2012
    Latest News
    Top HIPAA-Compliant Messaging Apps for Healthcare Teams
    June 25, 2025
    When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
    June 20, 2025
    Preventing Contamination In Healthcare Facilities Starts With Hygiene
    June 15, 2025
    Strengthening Healthcare Systems Through Clinical and Administrative Career Development
    June 13, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Medicaid Expansion: Will We get our Money’s Worth?
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Medicaid Expansion: Will We get our Money’s Worth?
Policy & Law

Medicaid Expansion: Will We get our Money’s Worth?

DavidEWilliams
Last updated: January 11, 2012 10:22 am
DavidEWilliams
Share
5 Min Read
SHARE

Should we just hand uninsured adult diabetics $1000 per year rather than enrolling them in Medicaid? That’s the question I’m left with after reading Medicaid Expansion Under Health Reform May Increase Service Use and Improve Access for Low-Income Adults With Diabetes in this month’s diabetes focused issue of Health Affairs.

Should we just hand uninsured adult diabetics $1000 per year rather than enrolling them in Medicaid? That’s the question I’m left with after reading Medicaid Expansion Under Health Reform May Increase Service Use and Improve Access for Low-Income Adults With Diabetes in this month’s diabetes focused issue of Health Affairs.

If the Patient Protection and Affordable Care survives the Supreme Court and the Republican Party, millions of uninsured, non-elderly, low-income adults will be newly eligible for Medicaid in 2014. The authors of the article compared diabetics on Medicaid to those who lacked insurance and found:

  • Much higher health care spending for those on Medicaid: $14,229 v. $3,498
  • Much higher out-of-pocket expenses for the uninsured: $1,446 v. $415
  • Better access to medical services by those on Medicaid
  • Better access to prescription drugs by those on Medicaid

Compared to their uninsured counterparts, diabetics on Medicaid go to the doctor more, use more prescription drugs, get admitted to the hospital more and go to the emergency room more.

More Read

China Syndrome: Rich Flee Mainland for Medical Care Abroad
How to Make the Decision Between a Long Term Facility and an In-Home Nurse for Elderly Relatives?
Will There Be Enough PCPs To Treat New Medicaid Patients?
How Do You Know if You’re Suitable for Medical School?
HOW Can VNA Help in Boosting the Healthcare Industry?

The authors would dearly love to say that outcomes for diabetics on Medicaid are better, but alas the evidence is lacking. A couple of process measures (HbA1c measurement and retinal exam) were significantly better for Medicaid patients but others –foot check, blood cholesterol measurement, flu vaccination– weren’t. (The authors cite poor sample size –but unfortunately the appendix, which is supposed to include more detail on these analyses is mysteriously absent from the Health Affairs website.)

There’s no attempt in the article to document real outcomes measures such as reduction in complications or even improved glycemic control.

I found this section of the discussion particularly discouraging:

“Taken together, the findings for spending, use, and access in our analysis indicate that Medicaid facilitates financial protection and access for enrollees with diabetes and complex health needs. The findings also indicate that currently uninsured adults with diabetes will probably experience increased utilization and improved access upon gaining Medicaid coverage.

Additional research is needed to understand Medicaid’s role in facilitating access to recommended diabetes care, because the literature on this topic has mixed conclusions.”

In other words, being in Medicaid definitely saves a diabetic enrollee money (how could it not?) and “probably” –but may not– improve access. (And there’s silence on outcomes.)

In the absence of more compelling evidence, there’s a pretty good argument to be made that the main impact of enrolling a diabetic in Medicaid provides doctors, hospitals, pharmaceutical companies et al. access to a paying customer to the tune of about $10,000 above what an uninsured diabetic yields. This is not the kind of access the authors want to talk about, but that’s what I read from the data.

From a purely financial standpoint maybe it would make more sense for the government to hand each uninsured diabetic $1000 per year (the difference in out-of-pocket costs between the Medicaid enrollee and the uninsured) and save the other $13,000 that’s captured by the health care system.

I’m not actually advocating such a policy, for three reasons:

  • Access to the health care system is important, and everyone deserves to have it
  • There probably is some outcomes benefit from being on Medicaid –it’s just not evident from the data presented in this article
  • We need to find a way to make Medicaid –and health insurance in general– useful for those with chronic illness. That can be done by reforming the delivery system

 


TAGGED:diabeteshealth reformMedicaid
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

women dental care
What Is a Smile Makeover and How Much Does It Cost?
Dental health
June 30, 2025
HIPAA-Compliant Messaging Apps
Top HIPAA-Compliant Messaging Apps for Healthcare Teams
Global Healthcare Policy & Law Technology
June 25, 2025
recovering from injury
Rebuilding After Injury: Path to Physical and Emotional Recovery
News
June 22, 2025
scientist using microscope
When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
Global Healthcare
June 18, 2025

You Might also Like

Uninsured, and Lovin’ It

June 10, 2011

Shaping the World’s Health Agenda: UN High-Level Meeting on NCDs

August 17, 2011

The Medical Marijuana Mess

August 30, 2014
Medicine Doctor
Health careMedical EducationPublic Health

5 Compelling Reasons to See a Functional Medicine Doctor

July 28, 2021
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?