Ever since President Donald Trump won the White House, Democrats, interest groups, and even some Republicans have argued that rolling back Obamacare would harm the health of millions. But a new study published in the National Bureau of Economic Research suggests Obama’s healthcare law does little to actually improve patient’s health outcomes.
The research shows that while Obamacare expanded patient access to doctors, nurses, and hospitals, it’s provided little-to-no actual health benefits. The authors analyzed data from the Behavioral Risk Factor Surveillance System, an annual medical survey conducted by the Centers for Disease Control. After two years of observations, survey respondents reported they enjoyed greater access to health insurance, primary care, and routine check-ups. Yet the authors observed almost zero overall improvement in physical health after the patients got covered by Obamacare.
Other studies have come to similar conclusions. After Oregon expanded their Medicaid program through a lottery in 2008, researchers at the Massachusetts Institute of Technology compared the health of individuals selected to enroll in Medicaid versus those who remained uninsured. After two years, they observed Medicaid recipients visited the doctor more, utilized more preventive care, and consumed more prescription drugs. But they saw no improvement in blood pressure, cholesterol, or blood sugar relative to the uninsured. Medicaid enrollees even visited the emergency room more frequently.
Health Spending Doesn’t Guarantee Good Health
As these studies demonstrate, patients will indeed take advantage of their expanded healthcare coverage. But health statisticians estimate medical care only determines around 11 percent of one’s health. By contrast, individual behavior, personal circumstances, and genetics are far greater determinants of personal health.
Health insurance can play an important role in protecting individuals against the crushing financial burdens of rare, catastrophic health care episodes. But Obamacare has pushed health insurance above and beyond this vital role, by mandating insurers cover a comprehensive list of routine “essential health benefits.” These include doctor’s visits, preventive care, pediatric services, and more.
This misguided push by government planners to subsidize comprehensive insurance comes at an enormous cost to taxpayers. In 2016, the federal government spent an estimated $110 billion expanding coverage through Obamacare’s insurance subsidies and Medicaid expansion. And over the next decade, the Congressional Budget Office estimates the healthcare law will spend an additional $1.9 trillion on health insurance of little value to patients.
Increasing Enrollment Hurts Needy Patients
Funding artificially-comprehensive insurance also hurts patients. Ever since the federal government began offering states preferential funding to expand Medicaid to relatively healthy able-bodied adults, states have diverted resources away from caring for the truly needy. Nearly 600,000 individuals with mental illnesses, developmental disabilities, and traumatic brain injuries sit on waiting lists across the country for home and community-based services. After Arkansas expanded Medicaid to 300,000 able bodied adults, their waiting list for disabled patient services grew 25 percent. Seventy-nine children and adults died waiting for care.
Fortunately, reform-minded policy makers want to return health insurance to its traditional role. The American Health Care Act promises to end Obamacare’s requirement that states cover routine health benefits for every Medicaid recipient. Without these mandated benefits, states will be free to shift able-bodied Medicaid recipients into inexpensive catastrophic coverage and redirect Medicaid funding towards truly needy beneficiaries. The AHCA would also let private health insurers offer less comprehensive coverage without essential benefits.
Forcing Obamacare Enrollment Doesn’t Help
Some critics argue catastrophic insurance that doesn’t cover routine treatments will threaten patient health. But experts have long recognized less comprehensive insurance can encourage patients to spend less without sacrificing their health.
In 1982, the Rand Corporation published a groundbreaking study that compared the health of patients with comprehensive insurance versus those with high deductible catastrophic coverage. After 11 years of observations, Rand discovered that patients with comprehensive Obamacare-like coverage consumed 20 to 30 percent more routine healthcare services. Yet their health was no different than those with catastrophic coverage.
This doesn’t mean comprehensive insurance is completely worthless. Some patients, particularly those with preexisting conditions like cancer or cardiovascular disease, require routine access to expensive medical treatments. But forcing everyone to enroll in Obamacare’s all-of-the-above insurance won’t make America healthier.