THE OREGON HEALTH INSURANCE EXPERIMENT: EVIDENCE FROM THE FIRST YEAR

In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income...

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Bibliographic Details
Published in:The Quarterly journal of economics 2012-08, Vol.127 (3), p.1057-1106
Main Authors: Finkelstein, Amy, Taubman, Sarah, Wright, Bill, Bernstein, Mira, Gruber, Jonathan, Newhouse, Joseph P., Allen, Heidi, Baicker, Katherine
Format: Article
Language:English
Subjects:
Credit insurance
Health care
Health expenditure
Health insurance
Health outcomes
Health services utilization
Hospital admissions
Insurance coverage
Lotteries
Low income
Low income groups
Medicaid
Mental health insurance
Oregon
P values
Public health
Self reports
Social policy
Studies
U.S.A
Uninsured people
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Summary:In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group.
ISSN:0033-5533
1531-4650
DOI:10.1093/qje/qjs020