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Unique Oregon study demonstrates value of health insurance

Oregon Health Study

July 12 - People are more likely to get care, stay healthy, feel better and avoid financial crisis when they have health insurance, a nationally watched Oregon study shows.

The findings, while they may sound like a "no-brainer," help put to rest questions long posed by critics of Medicaid and its Oregon version, known as the Oregon Health Plan. The new study found that Medicaid coverage for low-income people โ€” the centerpiece of Oregon's proposed health transformation โ€” boosts access to care, improves physical and mental health, and lowers out-of-pocket costs and medical debt.

"This study confirms what we already know: health insurance matters, and Oregon Health Plan coverage makes a difference," said Tina Edlund, Chief of Policy for the Oregon Health Authority, which oversees the Oregon Health Plan. "We also understand that skyrocketing costs have made the current system is unsustainable. That's why Oregon is proposing to transform its health system to improve care and reduce costs by focusing our efforts on prevention and the effective management of chronic illnesses - so people stay healthier and avoid costly emergency care.

The unique Oregon Health Study became possible only because a budget shortfall forced officials to make a painful choice three years ago, when they briefly reopened enrollment in the Oregon Health Plan โ€” and were immediately overwhelmed with applicants. Nearly 90,000 Oregonians applied, but the state had only enough money to cover 10,000. Officials decided to let a computer randomly choose the lucky 10,000.

Oregon's predicament had a silver lining for health researchers, including experts from Harvard and MIT, who saw a chance to test the impact of health coverage in a way never before possible. The random selection allowed researchers to track, interview and compare "winners" and "losers," measuring the difference insurance makes. The National Bureau of Economic Research published the one-year results this week.

Compared with the uninsured, newly covered people in the Oregon study were:

  • 25 percent more likely to call their health good or excellent
  • 40 percent less likely to say their health had worsened in the past year
  • 35 percent more likely to visit a clinic or doctor
  • 15 percent more likely to use prescription drugs
  • 30 percent more likely to get hospital care
  • 70 percent more likely to have a clinic or doctor's office to go to for care
  • 55 percent more likely to have a regular doctor
  • 20 percent more likely to monitor their cholesterol; women were 60 percent more likely to get a mammogram for breast cancer screening
  • 10 percent less likely to become depressed

While the insured spent 25 percent more, on average, than the uninsured, researchers said that was in line with projected costs for the national Medicaid expansion planned for 2014. Insurance did not affect emergency room use.

Coverage also reduced the financial burden on households. Newly insured people were 25 percent less likely to have unpaid medical bills sent to a collection agency and 40 percent less likely to borrow money or stop paying other bills to pay for medical bills.