Political Animal


May 06, 2013 11:50 AM A Real Medicaid Study

By Ed Kilgore

After a week of listening to conservatives demand the deepest respect for the social science findings of researchers looking at Medicaid in Oregon, Matt Yglesias has a very good idea:

The whole reason the Oregon study arose was that Oregon had enough money to give some additional people Medicaid benefits but not everyone. So they chose to run a lottery. A lottery is great from the viewpoint of experiment design, but the sample size here was tragically small. Meanwhile, the Florida legislature just refused to expand Medicaid to anyone even though the state’s Republican governor says he supports expansion. And Florida isn’t alone. Texas won’t be expanding Medicaid either. In fact, most of the deeply conservative states of the south and the plains won’t be expanding Medicaid. But these states—especially Texas and Florida—have much larger uninsured populations than smallish Oregon ever did. What’s more, the amount of money around to finance Medicaid expansion is really big. So if conservatives in Texas and Florida really want to get to the bottom of the whole Medicaid question, they now have a golden opportunity. They ought to apply for a waiver to get federal money to expand Medicaid to cover half the eligible population. Do a lottery, just like in Oregon. And do followup studies. That would give us a much larger sample and much stronger evidence.

Look at it this way, conservatives. You’re confident Medicaid is a really bad program that exhibits the worst features of the welfare state and turns the Sovereign States into agents of central government hegemony, right? So why not let the hated federal government pay for the definitive proof of Medicaid’s folly, which would save some big money in the long run? Yglesias’ snarky-sounding suggestion actually should be taken seriously as deserving a serious answer.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.


  • c u n d gulag on May 06, 2013 11:56 AM:


    But, nahgonnahappen!

    They know they're peddling BS - and they know enough rational people still believe in math and statistics and facts.

    So, since they can't dazzle anyone with their brilliance, or any new ideas, they have to keep baffling them with the same, tired, old BS.

    Yes, good, CRAPTCHA!
    dgnifyi data, indeed.

  • Mudge on May 06, 2013 12:05 PM:

    Although Yglesias is not know for his sense of humor, that must be a "tongue-in-cheek" proposal. Republican controlled states do not want any data that may contradict their presumptions and it is a bit harder to deny existing data (and studies cost money...the deficit!)than pontificate in the absence of data. I refer you to their (successful) attempts to subvert all studies of gun related health outcomes.

  • Lauren Marinaro on May 06, 2013 12:38 PM:

    That is one of the worst ideas I have ever heard, snarky or not. Never give someone, especially a Republican, the idea that they can ask CMS for a waiver for less than 100% of a Medicaid-eligible population. I will never consent, even to prove a point, to putting eligible populations in a Shirley Jackson short story. That's the fast track to block grants. Don't go there.

  • KK on May 06, 2013 12:45 PM:

    Why not just compare national out comes for people with insurance and people without? Medicaid is just health insurance after all ( at its basic, I know it covers disabled services as well, thank god and LBJ). If we want to restrict it to Medicaid, why not just study neighboring states such NM and Tex?
    Btw, Fla not covering Medicaid seems like fiscal suicide to me. Feds pick up most of this expansion and my guess is any State Controller worth his salt will find a way to push current costs on the new program, saving boatloads on the old. Not mention all the uninsured that use energency rooms.

  • hells littlest angel on May 06, 2013 12:53 PM:

    Every Republican knows that empiricism, statistics and double-blind studies are lies straight from the pit of hell.

  • biggerbox on May 06, 2013 2:02 PM:

    Empirical evidence is a liberal idea.

    All Republican ideas are self-evident and do not need justification, merely endless repeated assertion.

    Haven't you been paying attention?

  • Doug on May 06, 2013 5:48 PM:

    "...and turns the Sovereign States into agents of central government hegemony..." Ed Kilgore

    It's much easier to be a big fish if the pond is small...

  • Left Wing Conservative on May 06, 2013 7:43 PM:

    First of all, the fact that the residents who received Medicaid reported much less depression and stress and weren't forced into bankruptcy because of unpaid medical bills should be enough of a reason but secondly, diet, diet, diet. Michael Pollan suggested when Obamacare was first brought up that it would cause the insurance companies to become adversaries of Big Ag just as they had with Big Tobacco. Until our population starts eating real food again and not too much of it and get off their couches we probably won't see much real gain in medical outcomes.

  • Louis King on May 07, 2013 12:29 PM:

    I was getting some inoculations yesterday (yes, people on Medicare need vaccines, too) and I thought of the Oregon study results. We will need years to determine the effectiveness of inoculating those who "won" versus not inoculating those who didn't. Was there any part of the analysis that covered that?