February 19, 1999

A study of Massachusetts residents who lost Medicaid-funded health coverage shows that most were unable subsequently to find sufficient health insurance for themselves and their children. Those who remained uninsured reported difficulty receiving needed services, even though most of them had access to a health care provider. The study – led by MGH researchers – appears in the February issue of the Journal of Health Care for the Poor and Underserved.

Joel Weissman, PhD, the study's lead author, says: "We were interested in seeing whether people who've lost Medicaid coverage could find other insurance, whether their access to care was affected, and whether they could purchase insurance on their own. Even though these families maintained their relationships with safety-net health care institutions, they felt that their access to care was seriously compromised without Medicaid." Weissman is a member of the MGH-Partners Institute for Health Policy.

In 1995 and 1996 researchers conducted a telephone survey of 351 current or former patients of Neighborhood Health Plan. Among those terminated from Medicaid, 78 percent of respondents said at least one family member lacked health insurance. Only 11 percent of the uninsured indicated that they could pay $200 a month or more for coverage, and even at $50 a month, only 57 percent said they could buy insurance.

Eric Campbell, PhD, also of the MGH-Partners Institute for Health Policy and a study co-author, notes that the least expensive insurance available to nongroup subscribers in Massachusetts at the time of the study cost $350 a month for family coverage. "There appears to be a serious discrepancy between how much insurance costs and how much low-income people can pay."

Among respondents with serious health problems, people who lost Medicaid were three times as likely as those still covered to report difficulty getting needed care for those problems.

Overall, those without Medicaid were nine times as likely to say they could not get prescriptions filled and three times as likely to say they went without medical care because it was too expensive.