Medicaid Expansion Improves Health, Motivates Enrollees


Expanded Medicaid program in Michigan found to largely benefit the most vulnerable patients.

Vulnerable patients report that their health improved significantly after enrolling in their states’ expanded Medicaid program, a new study published in JAMA Network Open found.

Vulnerable Michigan residents who enrolled in the state’s expanded Medicaid program, known as the Healthy Michigan Plan, saw significant improvements in their health. Michigan is the country’s 10 most populous state, according to the press release.

Currently, more than 751,000 individuals are enrolled in the plan, which is up from the 675,000 enrolled in February before the coronavirus disease 2019 (COVID-19) pandemic hit Michigan. Program enrollees had incomes below or just above the federal poverty line, with an employment or self-employment rate of 57%.

The study was based on a survey conducted by the University of Michigan. The survey asked 3000 enrollees of the Healthy Michigan Plan about their health at 2 time points a year apart, according to the press release.

The percentage of respondents who called their health fair or poor dropped from approximately 31% in 2016 to 27% in 2017, researchers found. Even larger decreases were seen among individuals with the very lowest incomes, Black enrollees, and those who had 2 or more chronic conditions. Those who lived in the Detroit metropolitan area also saw their health dramatically improve. Additional survey data found that respondents who felt their health was fair or poor dropped even lower to 25.6% by 2018.

The study also found that the percentage who said the emergency department was their primary source of care dropped from 12% to 3%. Additionally, 85% of enrollees had seen a primary care provider in the past year. The same percentage of enrollees also said they had few problems paying medical bills since enrolling. The dental health of enrollees also increased, with 40% of respondents saying they had dental health improvement.

"It is rare to find a change in health policy that actually improves health of a target population in merely one year…The Healthy Michigan Plan model of expansion, which emphasized both insurance coverage and primary care, built on what we have learned from health systems around the globe,” study co-author and professor of Internal Medicine at the University of Michigan Susan D. Goold, MD, MHSA, MA, said in the press release.

The program also was found to motivate enrollees to be more responsible for their health, according to the press release. A special feature of the Healthy Michigan Plan included a health risk assessment, which 43% of enrollees said they completed. Of these enrollees, 91% said they are more motivated to take greater responsibility for their health.


Study: Medicaid expansion meant better health for the most vulnerable low-income adults (Press Release), Ann Arbor, MI, July 10, 2020 EurekAlert. Accessed July 13, 2020.

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