The Oregon Health Insurance Experiment
Findings of the Oregon Health Insurance Experiment
What’s the issue?
One of the principal strategies contained in the Affordable Care Act (ACA) to achieve near-universal health insurance coverage is expansion of eligibility for the Medicaid program. There has been much debate about whether expansion of the Medicaid program should be used to extend health care benefits to the low-income uninsured.
This brief summarizes findings of the Oregon Health Insurance Experiment, a randomized controlled study made possible by a unique lottery process used in 2008 to expand Medicaid coverage in the state. The study addresses many of the issues being considered by policy makers, including take-up rates and characteristics of enrollees; use of health services; health outcomes and measures of well-being; enrollee finances and medical debt; as well as indirect societal effects on labor markets, private insurance coverage, and participation in other public programs.
As ACA implementation continues, the findings of the Oregon Health Insurance Experiment can be useful to other states to help in estimating the impacts of Medicaid expansion on their budgets, designing programs to avoid some of the pitfalls experienced in Oregon such as enrollment strategies and benefit design, working with providers to meet increased demands for services, and developing broader strategies to improve the health status of enrollees.