A new study of Medicaid recipients in Oregon suggests that giving people Medicaid coverage increases their spending on health care but has no statistically significant effects on their physical health. It does reduce depression (although the mechanism is not entirely clear, since it does not seem to increase the use of anti-depressants in any statistically significant way) and improve financial security, and the study found some medical benefits that did not reach statistical significance. Since a great deal of Obamacare’s coverage expansion comes from expanding Medicaid, the study undercuts the arguments Obamacare proponents have been making for the last five years. Remember when supporters claimed that opposition amounted to killing people? The evidence for that view was always thin, and now it’s thinner.
Avik Roy and Megan McArdle have nice write-ups of the study, with Roy also covering the defensive spin of liberals about it. Phil Klein has a shorter write-up. An earlier version of the study seemed to show more positive results; Peter Suderman contrasts how liberals covered it then (this is “the gold standard in research) and how the same people are covering it now (the study is limited).
This doesn’t mean that expanding insurance coverage is valueless. The main gain, though, appears to be financial: the reduced risk of not being able to pay medical bills or suffering huge losses from them. (That’s why I have health insurance, for example, not because I think it will improve my health.) But there are many cheaper ways of realizing this gain: for example, we could reduce the regulatory and tax-policy obstacles to the development of a robust market in catastrophic health coverage. It seems highly likely that there are less wasteful means of reducing depression as well.