Medicaid: Why It’s Important

by Brian Smedley, Ph.D.

During one of the first opportunities that I had to present testimony at a Congressional hearing, a member of the committee posed a challenging question to me and other witnesses at our panel:  Would you trade your current health insurance for Medicaid?

The Congressman’s intent was clear:  he and others who oppose expansions of public health insurance programs believe that Medicaid is worse than private insurance, and possibly even worse than no insurance at all.

I was the first witness seated on the right of the panel, so I was to respond first.  I hesitated.  I didn’t want to reinforce the idea that Medicaid was deeply flawed.  Sure, the program has problems, but it remains one of the most efficient health insurance programs in the country and has been a lifeline for millions of low-income and disabled Americans.  But trade the insurance I had at the time?  I caved and answered no.  Almost all of the witnesses at our panel did the same.  But I’ve regretted it since.

Yesterday a landmark new study was released that, for the first time, documents the many ways in which Medicaid improves the health and well-being of its beneficiaries.  Researchers found that “expanding low-income adults’ access to Medicaid substantially increases health care use, reduces financial strain on covered individuals, and improves their self-reported health and well-being.”  The study was remarkable because for the first time researchers were able to compare outcomes for people who were randomly assigned to Medicaid against those who sought Medicaid coverage but could not receive it due to budget constraints.  (

The implications of the study are clear:  efforts to slash Medicaid, such as those being debated in Congress, would increase risks for poor health and financial ruin for millions of children, elderly, and/or disabled people.  These are the very folks who are struggling the most in the current economy.  And given the high cost of poor health for our nation as a whole, these cuts are not only morally wrong but also put our economic recovery at risk.

Medicaid works.  Let’s spread the word.  I wish I had when I was given the chance to correct the record.

Brian Smedley, Ph.D., is Vice President and Director of the Health Policy Institute at the Joint Center for Political and Economic Studies. To learn more about Dr. Smedley and the Health Policy Institute, visit the Joint Center website.

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