Oregon's Experience: Giving the Uninsured Health Insurance Good for All

By Deborah Hirsch
TMCnet Contributor

Some states are getting ahead of the curve with health insurance for all, even if the Supreme Court rules this week that the Obama Administration’s Affordable Care Act (ACA) is deemed unconstitutional. 

In 2008, Oregon opened its Medicaid rolls to some working-age adults living in poverty, according to a story by Annie Lowrey. Because the state didn’t have enough money to cover everyone, it held a lottery. 

With that lottery, according to Lowrey, Oregon “became a laboratory for studying the effects of extending health insurance to people who previously did not have it.”

Now, health economists point to the state as the single best place to study the one of prime questions as the Supreme Court prepares to rule: what are the costs and benefits of coverage?

Many experts predict the court will void all or part of the ACA, but a continuing study by a group of researchers following tens of thousands of Oregonians has found that “gaining insurance makes people feel healthier, happier and more financially stable,” Lowrey reports.

“The insured also spend more on healthcare, dashing some hopes of preventive-medicine advocates who have argued that coverage can save money – by keeping people out of emergency rooms, for instance,” she added. In Oregon, the newly insured went to the doctor and spent an average of $778 a year, or 25 percent more on healthcare than those who did not win insurance.

It’s true that expanded coverage benefits the public in many ways, but it also takes a huge chunk out of the federal government’s long-term budget responsibilities.

“The study put to rest two incorrect arguments that persisted because of an absence of evidence,” Katherine Baicker, a Harvard economist who worked on the study and served as an economic adviser to President George W. Bush, told Lowrey. “The first is that Medicaid doesn’t do anything for people, because it’s bad insurance or because the uninsured have other ways of getting care. The second is that Medicaid coverage saves money” by increasing preventive care, for instance.

“It’s up to society to determine whether it’s worth the cost,” she finished.