People die. That’s right, people die. So why should we help anybody with anything if we’re all destined for a dirt nap?
That was the jest of an argument against expanding Medicaid made by Idaho Freedom Foundation president Wayne Hoffman.
Hoffman and the IFF have long lobbied against the Affordable Care Act and Medicaid expansion.
Sadly, the IFF has successfully convinced Idaho’s GOP lawmakers that extending Medicaid coverage to 78,000 low-income workers is antithetical to the interests of the Republican Party.
Yet more and more, the human consequences of the GOP’s lack of action have mounted. Hard working Idahoans are struggling. Hard working Idahoans are suffering. Hard working Idahoans are dying.
It’s no longer an abstract concept. The body count is mounting.
Faced with these realities, Hoffman reached into the tea party playbook last week for a discredited claim: people are better off without Medicaid.
Hoffman says many studies prove him correct. However, only one study is the gold standard on this issue. It’s was done in Oregon.
The Oregon study is illuminating because the research used randomly selected groups – one group of 6,000 people was allowed enrollment in Medicaid while one group of 5,000 wasn’t.
Two years later, researchers concluded:
“We found that insurance led to increased access to and utilization of health care, substantial improvements in mental health, and reductions in financial strain, but we did not observe reductions in measured blood-pressure, cholesterol, or glycated hemoglobin levels.”
Of course, very few people want to be insured because they believe it will reduce glycated hemoglobin levels. Most want it for fear of medical bills.
“Insurance is about health, but it’s also about money. A major value of comprehensive health insurance is that it protects people from financial ruin if they have a horrible health emergency or an expensive long-term condition that requires treatment. A homeowner living near a river doesn’t buy flood insurance to prevent floods or protect his home if a flood occurs. He buys flood insurance so that if his house is destroyed, he will be able to recover financially. This too is a major purpose of health insurance. The latest results from Oregon showed that being on Medicaid ‘nearly eliminated catastrophic out-of-pocket medical expenditures.’ This matters and may be part of the reason earlier results from the ongoing Oregon study indicated that those on Medicaid were happier.”
It’s not surprising Hoffman avoided the conclusion of the Oregon study. It’s also not surprising he cited a study from John Hopkins University. He’s not the first tea partier to do so. A distorted version of the John Hopkins study that claims people with no health insurance are better off than people on Medicaid has been a prevailing prevarication on A.M. talk radio.
Here’s the problem: like most studies, the two groups being compared aren’t randomized, which is why the Oregon study is so important. Indeed, Hopkins researchers specifically sought out two distinct groups because they were looking for the differences between people on Medicaid, who tend to be the poorest and unhealthiest patients, and folks who do not have insurance, who tend to be less poor and in better health.
As one of the its coauthors explains, the study showed whether payer status was a patient’s predictor of risk.
“[The] purpose of the studies was not to show, and does not show, that the Medicaid program negatively affects patients’ health.”
As the body count piles up, Idaho politicians have yet to come up with a reason for not expanding Medicaid other than “political realities.”
Those political realities have human costs. And the bill is coming due.