New York, NY, June 24, 2015—In 2014, 95 percent of people who got their health insurance through Medicaid and were covered all year had a regular doctor, and 55 percent said they received excellent or very good care, according to a new Commonwealth Fund report. Medicaid enrollees had similar experiences to people with private insurance, of whom 94 percent had a regular doctor and 53 percent reported good care. In contrast, 77 percent of people without any health insurance said they had a regular doctor and only 40 percent said they received good care.
The report, Does Medicaid Make a Difference? Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2014, compares the experiences of adults ages 19 to 64 who had Medicaid, had private insurance, or spent some time during the year without coverage. The researchers find that Medicaid beneficiaries have good experiences with their doctors—53 percent got a same- or next-day appointment the last time they were sick, compared to 43 percent of uninsured adults. When getting care from their doctor, 67 percent of those with Medicaid said their doctor always or often coordinated their care with other providers, compared to 55 percent of the uninsured.
“Medicaid provides millions of Americans with health insurance, and it is important to track how that insurance is working for them,” said study coauthor Sara Collins, Vice President for Health Care Coverage and Access at The Commonwealth Fund. “These results indicate that on many measures Medicaid works nearly as well as, and sometimes better, than private insurance and is helping people get and afford the care they need.”
According to the analysis, which uses findings from the Commonwealth Fund 2014 Biennial Health Insurance Survey, Medicaid provides good financial protection, often better than that provided by private coverage. Fewer than one in five (19%) Medicaid beneficiaries reported having trouble paying their medical bills, having to change their way of life to pay bills, being contacted by a collection agency about an unpaid bill, or paying off medical debt over time. In contrast, a third (33%) of people with private insurance and 47 percent of those uninsured during the year reported at least one of those problems.
Medicaid Beneficiaries Are Getting Preventive Care
To assess the effects of having insurance coverage, the Commonwealth Fund researchers controlled for differences in income, race, age, gender, and health status. They found that Medicaid enrollees are more likely than people without insurance to get preventive care and that enrollees receive preventive care at rates statistically equivalent to rates for the privately insured.
“These findings show that it is better to have Medicaid than to not have any health insurance at all,” said Commonwealth Fund President David Blumenthal, M.D. “In crucial areas like preventive care and being able to see a doctor when you’re sick, people with Medicaid are doing much better than those who are uninsured. And, in most areas, Medicaid enrollees are doing as well as or better than those with private insurance.”
The Commonwealth Fund Biennial Health Insurance Survey, 2014, was conducted by Princeton Survey Research Associates International from July 22 to December 14, 2014. The survey consisted of 25-minute telephone interviews in either English or Spanish and was con¬ducted among a random, nationally representative sample of 6,027 adults ages 19 and older liv¬ing in the continental United States. A combination of landline and cellular phone random-digit dial samples was used to reach people.
The sample was designed to generalize to the U.S. adult population and to allow sepa¬rate analyses of responses of low-income households. This report limits the analysis to respon¬dents ages 19 to 64 (n=4,251). Statistical results are weighted to correct for the stratified sample design, the overlapping landline and cellular phone sample frames, and disproportionate non¬response that might bias results.
The resulting weighted sample is representative of the approximately 182.8 million U.S. adults ages 19 to 64. The survey has an overall margin of sampling error of +/– 2 percent¬age points at the 95 percent confidence level. The landline portion of the survey achieved a 15.8 percent response rate and the cellular phone component achieved a 13.6 percent response rate.
The analysis groups respondents by insurance status and includes adults insured all year with private coverage (n=2,269), those insured all year with Medicaid (n=327), and those who were uninsured when surveyed or at some point during the past year (n=1,219). The adjusted percentages presented in this brief take into account the underlying differences in health status and demographics between those insured by private insurance, Medicaid, and uninsured populations.