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What is Medicaid's Impact on Access to Care, Health Outcomes, and Quality of Care? Setting the Record Straight on the Evidence

Introduction
  1. Gottlieb S, “Medicaid is Worse than No Coverage at All,” Wall Street Journal online, March 10, 2011. http://online.wsj.com/article/SB10001424052748704758904576188280858303612.html

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  2. The Path to Prosperity: A Responsible Balanced Budget. Fiscal Year 2014 Budget Resolution, House Budget Committee, March 2013. http://budget.house.gov/fy2014/      

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  3. Senator Ted Cruz, PolitiFact.com, reported in Tampa Bay Times, April 1, 2013.  

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  4. Dayaratna K, “Studies Show: Medicaid Patients Have Worse Access and Outcomes than the Privately Insured,” Heritage Foundation Backgrounder No. 2740, November 9, 2012.

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  5. Roy A, “Why Medicaid is a Humanitarian Catastrophe,” Forbes, March 2, 2011. http://www.forbes.com/sites/aroy/2011/03/02/why-medicaid-is-a-humanitarian-catastrophe/

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  6. Representative Bill Cassidy, C-Span interview, February 8, 2011. Accessed April 29, 2013 at http://thinkprogress.org/politics/2011/02/08/142979/cassidy-medicaid/

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  7. Care without Coverage: Too Little, Too Late, Committee on the Consequences of Uninsurance, Board on Health Care Services, Institute of Medicine, National Academy Press, 2002. (Page 6)

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Issue Brief
  1. Coverage Matters: Insurance and Health Care, Committee on the Consequences of Uninsurance, Board on Health Care Services, Institute of Medicine, National Academy Press, 2001. (Page 28)

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  2. Aday L and R Andersen, “A Framework for the Study of Access to Medical Care,” Health Services Research 9(3), Fall 1974.

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  3. Dubay L and G Kenney, “Health Care Access and Use among Low-Income Children: Who Fares Best?” Health Affairs 20(1), 2001.

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  4. Howell E and G Kenney, “The Impact of the Medicaid/CHIP Expansions on Children: A Synthesis of the Evidence,” Medical Care Research and Review 69(4), August 2012.

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  5. Selden T and J Hudson, “Access to Care and Utilization Among Children: Estimating the Effects of Public and Private Coverage,” Medical Care 44(5), 2006.

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  6. Kenney G and C Coyer, National Findings on Access to Health Care and Service Use for Children Enrolled in Medicaid or CHIP, MACPAC Contractor Report No. 1, March 2012.

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  7. Howell E, “The Impact of the Medicaid Expansions for Pregnant Women: A Synthesis of the Evidence,” Medical Care Research and Review 58(1), March 2001.

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  8. Long S et al., “How Well Does Medicaid Work in Improving Access to Care?” Health Services Research 40(1), February 2005.

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  9. Long S et al., National Findings on Access to Health Care and Service Use for Non-elderly Adults Enrolled in Medicaid. MACPAC Contractor Report No. 2, June 2012.

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  10. Coughlin T et al., “What Difference Does Medicaid Make? Assessing Cost Effectiveness, Access, and Financial Protection under Medicaid for Low-Income Adults,” Kaiser Commission on Medicaid and the Uninsured, May 2013.

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  11. DeLeire T et al., “Wisconsin Experience Indicates that Expanding Public Insurance to Low-Income Childless Adults has Health Care Impacts,” Health Affairs 32(6), June 2013.

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  12. Baicker K and A Finkelstein, “The Effects of Medicaid Coverage – Learning from the Oregon Experiment,” The New England Journal of Medicine 365(8), August 25, 2011. (Also see Finkelstein et al., The Oregon Health Insurance Experiment: Evidence from the First Year, NBER Working Paper 17190, 2011. http://www.nber.org/papers/w17190)

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  13. Baicker K et al., “The Oregon Experiment – Effects of Medicaid on Clinical Outcomes,” The New England Journal of Medicine 368(18), May 2, 2013.

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  14. Kronick R and A Bindman, “Protecting Finances and Improving Access to Care in Medicaid,” The New England Journal of Medicine 368(18), May 2, 2013.

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  15. Garfield R and A Damico, “Medicaid Expansion under Health Reform May Increase Service Use and Improve Access for Low-Income Adults with Diabetes,” Health Affairs 31(1), January 2012.

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  16. The Role of Medicaid for Adults with Chronic Illnesses, Kaiser Commission on Medicaid and the Uninsured, November 2012.

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  17. Ku L et al., Improving Medicaid’s Continuity of Coverage and Quality of Care, The George Washington University Department of Health Policy, July 2009.

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  18. Kasper J et al., “Gaining and Losing Health Insurance: Strengthening the Evidence for Effects on Access to Care and Health Outcomes,” Medical Care Research and Review 57(3), September 2000.

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  19. Cassedy A et al., “The Impact of Insurance Instability on Children's Access, Utilization, and Satisfaction with Health Care,” Ambulatory Pediatrics 8(5), September-October 2008. 

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  20. Carlson M et al., “Short-Term Impacts of Coverage Loss in a Medicaid Population: Early Results from a Prospective Cohort Study of the Oregon Health Plan,” Annals of Family Medicine 4(5), September/October 2006.

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  21. Lurie N et al., “Termination from Medicaid: Does it Affect Health?” The New England Journal of Medicine 311(7), August 16, 1984. 

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  22. Eliminating Adult Dental Coverage in Medicaid: An Analysis of the Massachusetts Experience, Kaiser Commission on Medicaid and the Uninsured, August 2005.

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  23. Currie J and J Gruber, “Health Insurance Eligibility, Utilization of Medical Care, and Child Mortality,” Quarterly Journal of Economics 111(2), 1996.

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  24. Sommers B et al., “Mortality and Access to Care among Adults after State Medicaid Expansions,” The New England Journal of Medicine 367(11), July 25, 2012.

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  25. Weissman J et al., “State Medicaid Coverage and Access to Care for Low-Income Adults,” Journal of Health Care for the Poor and Underserved 19(1), February 2008.

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  26. Health, United States, 2012, National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, May 2013.

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  27. 2012 Annual Report on the Quality of Care for Children in Medicaid and CHIP, U.S. Department of Health and Human Services, December 2012.

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  28. Kenney and Coyer, March 2012, Op. cit.

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  29. Long et al., June 2012, Op. cit.  

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  30. Long et al., February 2005, Op.cit.

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  31. Coughlin T et al., “Assessing Access to Care under Medicaid: Evidence for the Nation and Thirteen States,” Health Affairs 24(4), July/August 2005.

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  32. Coughlin et al., May 2013, Op.cit.

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  33. Anum E et al., “Medicaid and Preterm Birth and Low Birth Weight: The Last Two Decades,” Journal of Women’s Health 19(3), 2010.

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  34. Kogan M et al., “State Variation in Underinsurance among Children with Special Health Care Needs in the United States,” Pediatrics 125(4), April 2010.

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  35. Magge H et al., “Prevalence and Predictors of Underinsurance aong Low-Income Adults,” Journal of General Internal Medicine, February 2013.

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  36. Coughlin et al., May 2013, Op.cit.

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  37. Skinner A and M Mayer, “Effects of Insurance Status on Children’s Access to Specialty Care: A Systematic Review of the Literature,” BMC Health Services Research 7(194), 2007.

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  38. Bisgaier J and K Rhodes, “Auditing Access to Specialty Care for Children with Public Insurance,” The New England Journal of Medicine 364(24), June 16, 2011.

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  39. Medicaid and CHIP: Most Physicians Serve Covered Children but Have Difficulty Referring them for Specialty Care, Government Accountability Office, June 2011.

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  40. Asplin B et al., “Insurance Status and Access to Urgent Ambulatory Care Follow-up Appointments,” Journal of the American Medical Association 294(10), September 2005.

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  41. Long et al., June 2012, Op.cit.

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  42. Coughlin et al., May 2013, Op. cit.

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  43. Garcia T et al., “Emergency Department Visitors and Visits: Who Used the Emergency Room in 2007?” NCHS Data Brief No. 38, May 2010.

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  44. Sommers A et al., “Dispelling Myths about Emergency Department Use: Majority of Medicaid Visits are for Urgent or More Serious Symptoms, HSC Research Brief No. 23, July 2012.  

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  45. Cheung P et al., “Changes in Barriers to Primary Care and Emergency Department Utilization,” Archives of Internal Medicine 171(15), August 2011.

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  46. O’Malley A, “After-Hours Access to Primary Care Practices Linked with Lower Emergency Department Use and Less Unmet Medical Need,” Health Affairs 32(7), December 2012. 

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  47. Gindi R et al., Emergency Room Use among Adults Aged 18-64: Early Release of Estimates from the National Health Interview Survey, January–June 2011, National Center for Health Statistics, May 2012. 

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  48. Rhodes K et al., “’Patients Who Can’t Get an Appointment Go to the ER’: Access to Specialty Care for Publicly Insured Children,” Annals of Emergency Medicine 61(4), April 2013.

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  49. Kangovi S et al., “Understanding Why Patients of Low Socioeconomic Status Prefer Hospitals over Ambulatory Care,” Health Affairs 32(7), July 2013.

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  50. Shin P et al., Quality of Care in Community Health Centers and Factors Associated with Performance, Kaiser Commission on Medicaid and the Uninsured, June 2013.

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  51. Weissman J et al., “The Quality of Hospital Care for Medicaid and Private Pay Patients,” Medical Care 51(5), May 2013.

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