Americans unlikely to move to get better Medicaid benefits: study

BOSTON Mon Jan 6, 2014 4:04pm EST

The federal government forms for applying for health coverage are seen at a rally held by supporters of the Affordable Care Act, widely referred to as ''Obamacare'', outside the Jackson-Hinds Comprehensive Health Center in Jackson, Mississippi October 4, 2013. REUTERS/Jonathan Bachman

The federal government forms for applying for health coverage are seen at a rally held by supporters of the Affordable Care Act, widely referred to as ''Obamacare'', outside the Jackson-Hinds Comprehensive Health Center in Jackson, Mississippi October 4, 2013.

Credit: Reuters/Jonathan Bachman

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BOSTON (Reuters) - Americans are unlikely to move to another state to obtain better medical coverage, according to a Harvard study released on Monday that debunks fears expanded Medicaid in some states under the U.S. Affordable Care Act will trigger big and costly migrations.

The study could scratch one item off a long list of complications plaguing President Barack Obama's launch of his sweeping health care law, also known as Obamacare, which kicked in January 1.

About half of U.S. states have opted to expand Medicaid eligibility to poor Americans under the law, raising concerns those states could attract low-income people from elsewhere, increasing the burden on state budgets.

"This is known as the welfare magnet hypothesis," according to the study from the Harvard School of Public Health, which said its research into previous state medical aid expansions "found no evidence of significant migration effects."

The Harvard study used U.S. migration data from 1998 to 2012 to focus on the impact of medical insurance expansions in Arizona, Maine, New York, and also Massachusetts - whose own health care reforms served as a model for the Affordable Care Act.

"These results suggest that migration will not be a common way for people to obtain Medicaid coverage under the current expansion and that interstate migration is not likely to be a significant source of costs for states choosing to expand their programs," according to the study.

"Our findings are relevant for forecasting the cost and coverage consequences of states' decisions about expanding Medicaid eligibility," it said, noting four states - New Hampshire, Pennsylvania, Missouri, and Utah - are still considering whether to expand Medicaid under the law.

Arguments in favor of expanding Medicaid eligibility have tended to focus on improving access to medical care for the poor and bringing in federal dollars to bolster states' social programs, while counterarguments have focused on the potential unintended costs to state budgets.

A joint Harvard-MIT study released last week focusing on Oregon's expanded Medicaid program, for example, showed adults covered by Medicaid used emergency rooms 40 percent more than those in similar circumstances who are uninsured.

MIT led another study in 2013 focusing on Oregon that showed "Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years" but "did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain."

The latest Harvard findings come after a rocky start for the Affordable Care Act, which relies on a website that suffered repeated crashes, glitches, and security concerns that hampered enrollment. After some fixes, more than 2 million people have been able to enroll for coverage under the law, the most sweeping social program since the 1960s.

President Obama has also been criticized for telling Americans they would be able to keep their old insurance plans under the new law if they wanted to - an assertion that turned out to be false in many cases.

The law was passed in 2010 to help millions of uninsured and under-insured Americans, but Republicans have opposed the reform as an unwarranted expansion of the federal government and say it is too costly and eliminates healthcare choices for many.

(Reporting by Richard Valdmanis; Editing by Phil Berlowitz)

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