What Medicaid Expansion in Oregon Really Tells Us

My last post commented on (okay, lambasted) a recent column in the Missoulian by Fred Thomas, in which the senator tries to justify the unjustifiable failure of the Montana Legislature to expand Medicaid coverage. In part, Thomas claims that the Legislature did the right thing because expanding Medicaid would have “blown a hole” in the state budget. That’s an argument that I think I’ve disposed of, although I’ll have a little more to say about it in a future post.

Thomas’s other claim is that expanding Medicaid will not do the newly covered any good, and he cites a study in the New England Journal of Medicine to prove it. He extracts this quote from the study, which compared the outcomes of 6,387 Oregonians who got Medicaid coverage to those of 5,842 who did not:

“This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured health outcomes in the first two years.”

Now I’m no expert on health care studies, but I can read. And what I read tells me that Thomas was pretty selective in quoting the New England Journal study. He’s even been a little selective in quoting the single sentence, because he left off half of it! The whole sentence reads:

“This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured health outcomes in the first two years, but it did increase the use of health care services, raise rate of diabetes detection and management, lower rates of depression and reduce financial strain.”

Apparently Thomas doesn’t think that giving people adequate medical care, managing their diabetes, helping them avoid depression, and saving them from medical bankruptcy are worth much.

Like I say, I’m no expert, but I don’t think Thomas is either. And no doubt each of thinks the other has an axe to grind. So if you want to find out what really happened in Oregon, take a look at this KUFM commentary from last May by Dr. Tom Roberts, who knows this stuff inside and out.* You’ll be glad you did.

* Since I originally posted this comment, I realized that Thomas wasn't the first Montana Republican to bash Medicaid expansion. Former state senator Joe Balyeat took his best shot at it in the Missoulian and Tom Roberts responded in print. All that may amount to more than you want to read, but if really want to get down in the weeds, you can read the study itself. Click here.