I have high regard for Nicholas Bagley. So when he sends me something with an endorsement, I pay attention. Today, he sent me a link to a paper on Medcaid and Medicaid expansion by Mark Hall, which includes this passage:
Some conservative policy advocates claim either that people are worse off being on Medicaid than being uninsured, or that they would be substantially better off if the government fundamentally restructured Medicaid or replaced it with an entirely different program.50 The implausible (if not preposterous) argument that people are worse off with Medicaid than with nothing at all rests on a handful of studies reporting that Medicaid patients do worse in some particular medical settings than do uninsured patients.[51] Highly regarded health economist Austin Frakt has thoroughly and convincingly debunked these studies, and this entire line of argument, as follows.52
Frakt explains that observational studies that compare uninsured people with those covered by Medicaid are completely inadequate for drawing conclusions about whether Medicaid coverage causes worse health.53 This is because people do not sort themselves randomly between insurance conditions.54 All else being equal, sick people are more likely to seek out insurance, including Medicaid.55 As a result, uninsured people are, in general, substantially healthier than people with Medicaid.56 Therefore, it is almost certainly spurious to conclude that Medicaid is the cause of the worse health observed in those whom it covers.
I’m flattered. Nick has high regard for Mark, as do I, writing me that he thinks he’s “among the best health law scholars in the country, if not the very best.”
The work Mark cites by me is coauthored by Aaron, Harold Pollack, and Uwe Reinhardt, all highly regarded as well. Click through for the details. It appears to have been published in 2014, but I don’t recall having seen it.
