The Oregon Health Insurance Experiment

As reported in a New York Times article, sign-ups for Medicaid, the federal insurance program for the poor, have surged in many states as Medicaid eligibility has been expanded.  Most of those signing up for Medicaid coverage were previously uninsured.  Experts are hopeful that it will lead to better health outcomes for poor Americans, but the actual effects of the expansion of Medicaid coverage are unknown at this point.

One study however, the Oregon Health Insurance Experiment, offers some clues regarding the effect of expanding public health insurance on the health care use, health outcomes, financial strain, and well-being of low-income adults.  In 2008, the state of Oregon drew names by lottery for its Medicaid program for low-income, uninsured adults, allowing for a randomized controlled design study of the costs and benefits of expanding public health insurance.

Analyzing four years of data, researchers found that Medicaid enrollment:
  • had  no statistically significant effect on employment or earnings.
  • increased receipt of food stamps, but had little, if any, impact on receipt of other government benefits, including SSDI.
  • had no statistically significant effect on physical health markers, such as blood pressure, cholesterol or glycated hemoglobin (a measure of diabetic blood sugar control), or on the diagnosis of or medication for blood pressure or cholesterol.  However, it increased the probability of being diagnosed with diabetes after the lottery (by 3.8 percentage points, relative to a base rate of 1.1) and use of diabetes medication (by 5.4 percentage points, relative to a base rate of 6.4).
  • reduced observed rates of depression by 30% (by 9.2 percentage points, relative to a base of 30).  Also, there was no statistically significant increase in the use of medication for depression, but Medicaid increased the probability of being diagnosed with depression after the lottery (by 3.8 percentage points, relative to a base of 4.8).
  • eliminated out-of-pocket catastrophic medical expenditures and reduced the probability of having to borrow money or skip paying other bills because of medical expenses by more than 50%.
  • increased the use of preventive care, including an increase in cholesterol monitoring of 50 percent and a doubling of mammograms.
Read more: resources:
Sociology of Healthcare (
WEAT: Web Enabled Analysis Tool (
IHME: Data Visualizations (
Social Class and Health: A Data-Driven Learning Guide (
Frederique Laubepin

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