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
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
"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
"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
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.
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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
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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