Commonwealth Fund Releases Study Comparing People with Medicaid to Uninsured and Those with Private Insurance

Last week, the Commonwealth Fund released a study comparing the experiences of working-age adults with various insurance statuses over the course of a year. Specifically, the study compared:

• those with Medicaid;
• those with private or employer-sponsored insurance;
• and those without insurance.

With more than 70 million Americans covered by Medicaid, and an estimated 12 million gaining coverage under the Affordable Care Act’s Medicaid expansion, it is important to know how people’s experience of that coverage stacks up to private coverage and to being uninsured.

The findings indicate that the level of access to health care that Medicaid coverage provides is comparable to that afforded by private insurance. Adults with Medicaid coverage reported better care experiences than those who had been uninsured during the year and had fewer problems paying medical bills than either the privately insured or the uninsured.

Respondents were asked about their access to health services and their perceived quality of care. Medicaid enrollees were as likely as those with private insurance, and significantly more likely than those who were uninsured, to report having a regular source of care. Medicaid enrollees rated the quality of their care as highly as privately insured adults did and significantly higher than uninsured adults.

People enrolled in Medicaid reported getting same-day appointments at a somewhat lower rate than that for people with private coverage and at a slightly higher rate than uninsured patients, but neither difference was statistically significant. Likewise, there were no significant differences between the three groups in reported wait times for specialist appointments.

Respondents were also asked whether they received a variety of preventive and screening services, including blood pressure and cholesterol checks, flu shots, pap tests, mammography, and colon cancer screening. Compared to those who were  uninsured during the year, people  with Medicaid coverage were significantly more likely to report having received these services.

People with Medicaid  were significantly less likely than either privately insured or uninsured individuals to report having difficulty paying medical bills within the past year, having to change their way of life to pay medical bills, or to be paying off medical debt over time. They were also less likely to report skipping needed services in the past year because of the cost of care than adults who were privately insured or uninsured. Differences between adults with Medicaid and those with private insurance were statistically significant and the gaps were sometimes substantial. For example, privately insured adults reported skipping a recommended medical treatment, tests, or follow-up visits because of the cost at rates more than twice as high as those for people with Medicaid.

Read the study.