While Gov. Paul LePage and Democrats in the Legislature continue a seemingly endless war of words over Medicaid expansion, Massachusetts-based researchers recently released a study that examines the effectiveness of such expansions.

Will expanding Medicaid be a net benefit for Maine? How does the research compare to the rhetoric? LePage last week vetoed a bill that would have expanded Medicaid and reimbursed hospitals for money they were owed by the state.

Harvard health economics professor Katherine Baicker, the lead author of the study released this year about Oregon’s Medicaid expansion in the late 2000s, told the Maine Sunday Telegram that its results are not a victory for either side of the debate.

She said that hasn’t prevented both sides from spinning the report, published in the New England Journal of Medicine, for political purposes.

“There are two equally unrealistic points of view,” Baicker said. “It’s not a black-and-white issue.”

She said the research, which included nearly 60,000 people followed over two years, did not find that expanding Medicaid saved money for the government, as liberal politicians often claim.


“I don’t see any evidence that expanding Medicaid saves the government money,” she said. “You would not say that food stamps save the government money. It’s providing a service by giving people money to buy food. Expanding Medicaid is providing a service to people that costs money.”

While its effect on state governments was not part of the research, an expansion of Medicaid should not be burdensome for states because the federal government is reimbursing them for most of the cost of the program, Baicker said. The costs mostly will be felt at the federal level, she said.

The Affordable Care Act reimburses 100 percent of the expansion for the first three years, starting in 2014, cutting the reimbursement to 90 percent in future years. LePage and Republicans have said that they are skeptical the federal government would continue to reimburse Medicaid expansions at such a high rate.

Conservative politicians often make it seem like the expansion would not be beneficial to its recipients, and that also is not true, Baicker said. The researchers examined the health of randomly selected Oregon Medicaid recipients with a control group that had the same demographics but were not selected to receive Medicaid.

“We found a substantial improvement in their financial well-being, eliminating catastrophic out-of-pocket costs,” she said. “There also was a big improvement in mental health.”

But she also said that researchers did not find any significant improvement in “physical health,” even though Medicaid recipients used the health care system at a higher rate than those who did not have insurance.

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