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HIX Competitiveness in Doubt; IPAB Stalled

Jacqueline Fellows, for HealthLeaders Media, May 8, 2013

Effectiveness of Health Insurance Still Uncertain
A study examining Oregon's Medicaid population in 2008 showed that having health insurance had little impact on the health of enrollees. Results from the first year of the study were published in 2012, but there was no definite determination made about the correlation between health and health insurance.

This time, with two years of results, the study's author, MIT economist Amy Finkelstein, was ready to point to the data with the conclusion that having health insurance is no guarantee that the health of the person covered will be better.

The study followed two groups of Medicaid patients. One group of patients was covered; the other was not. The study found what it characterized as "no significant improvements" in the health of those who were covered by Medicaid, though some healthcare analysts may argue that the increased rates of diabetes detection and management as well as lower rates of depression are significant.

Oregon's study isn't the first to point out that health insurance doesn't necessarily lead to better health. But, the study could have a chilling effect on patient engagement activities if health systems and hospitals don't believe the small improvements made are significant enough to put a dent in chronic health conditions.

As Ezra Klein, writing in the Washington Post puts it, "The problem with the Oregon study is that it doesn't help us figure out how to make health care or health insurance better."

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