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Study: Medicaid, private insurance give same access to health care

The Government Accountability Office recently took a deep dive into the Medicaid program. What it found was surprising: Medicaid beneficiaries tend to have nearly as good access to medical care as those on private coverage, despite the public program generally offering doctors lower payments.

The key chart is here, which shows the percent of individuals reporting difficulty obtaining medical care between 2008 and 2009, broken down by insurance status:

There is a relatively big gap in dental care. That probably has to do with the number of states that do not include dental coverage in their benefit package. 

When it came to medical care and prescription medicine though, Medicaid patients reported no more challenges finding doctors than those on private coverage (the GAO researchers note that the differences in those categories, shown above, are not statistically significant). And they were certainly better off than those with no coverage at all.

Not all groups of Medicaid patients, however, have equal access. While children tended to have equal access to doctors regardless of their insurance source, adults on Medicaid fared worse than those on private insurance.

"About 7.8 percent of working-age adults with fullyear Medicaid reported difficulty obtaining care compared with 3.3 percent of similar adults with private insurance—a statistically significant difference," the report notes.

We also don't know about the quality of health care that patients receive, at least not from this study. Separate research suggests that Medicaid patients have worse outcomes than those with private insurance. Other studies, however, find it's better than having no insurance at all, as state expansions of Medicaid programs correlates with a higher life expectancy. 

The GAO report also did a bit of digging on why patients didn't make it to the doctor. It found the biggest obstacle not to be wait times or difficulty scheduling an appointment, but rather a lack of transportation.

The transportation challenge was unique among those on Medicaid: It didn't come up nearly as much with those on private insurance, or those with no coverage at all.



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Ezra Klein · November 19, 2012

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