Patients enrolled in Medicaid have worse survival rates than those with private insurance or even no insurance at all, according to a new study focused on Ohio Medicaid recipients published in the journal Cancer.
Researchers Siran Koroukian, Paul Bakaki, and Derek Raghavan compared survival and five-year mortality with Medicaid status in more than 11,000 Ohio adults aged 15 to 54 years and diagnosed in the years 1996-2002 with eight highly treatable cancers. They also sorted the Medicaid enrollees into two categories—those enrolled at the time of their diagnosis and those enrolled afterwards—to get more insight into how coverage impacts outcomes.
The researchers found that compared with non-Medicaid recipients, patients in the Medicaid pre-diagnosis and peri/post-diagnosis groups experienced unfavorable survival outcomes. Of the non-Medicaid patients, fewer than one in 10 died within five years of their cancer diagnosis, whereas more than one in five Medicaid patients died during that period.
Consistent With Other Research
According to Raghavan, who undertook the research while working at the Cleveland Clinic and now heads the Levine Cancer Institute in North Carolina, the team’s research illustrates how Medicaid can fall short of providing sufficient care.
“While Medicaid is potentially lifesaving, it is better to be able to support yourself and have insurance that protects at a higher level than just Medicaid,” Raghavan said in a press statement.
Devon Herrick, a senior fellow with the National Center for Policy Analysis, says Raghavan’s findings are consistent with other research.
“Dr. Raghavan is observing what many others have found: Medicaid is inferior to private coverage. Several studies have found Medicaid enrollees have a tougher time getting physician appointments than either the uninsured or the privately insured. Doctors who accept Medicaid patients are sometimes ‘Medicaid mills’ that run patients through [the system] like cattle through a corral,” explained Herrick.
Harder Time Finding a Doctor
Herrick notes the Medicaid program does not guarantee enrollees timely access to high-quality care because reimbursements are so low many physicians will not treat Medicaid patients.
“Theoretically, Medicaid enrollees are eligible for the same cancer care as the privately insured. However, some doctors will not accept Medicaid, so Medicaid enrollees have a harder time finding a doctor and often have to accept whoever they find regardless of reputation or experience,” said Herrick.
Obama’s Law Expands Medicaid
Dr. Karin Rhodes, who directs the Division of Health Policy Research at the University of Pennsylvania School of Medicine in Philadelphia, says this study indicates the need for President Obama’s health care law.
“It is actually the impact of being uninsured. This really highlights the importance of fully implementing the Affordable Care Act (PPACA) and getting everybody fully insured,” she told Reuters.
Herrick, however, says Rhodes’s argument “is rather short-sighted given that half of those expected to gain coverage under the PPACA will be covered by Medicaid.”
“Past research has found that between half and three-quarters of people newly covered after a Medicaid expansion were previously insured with private coverage. Some of these newly eligible under PPACA will succumb to the temptation of free coverage and find they have less access to care when they need it,” Herrick explained.
