Results from a recent study conducted by OSF Healthcare and Bradley University show that expanding Medicaid to more people hasn’t increased underserved populations’ access to healthcare as much as lawmakers have hoped.
The study analyzed the impact that Illinois’ Medicaid expansion has had in terms of rates of insurance coverage and access to care, including medical services, dental care, pharmaceuticals and mental health counseling. Survey data was collected in 2012, which was before the Medicaid expansion in Illinois, and in 2015, which was about a year after the expansion.
The researchers found that the state’s Medicaid expansion reduced the uninsured rate in both rural and urban counties, as well as increased access to all types of healthcare, with the biggest increase in dental coverage.
While Medicaid expansion has improved overall access to care, the most vulnerable populations — people with the lowest incomes, people of color and younger people — are still not benefiting equally from the expansion, the researchers concluded.
The findings mean that healthcare providers have a huge opportunity to help high-risk adults enroll in and use their Medicaid coverage. The study shone a light on where hospitals should focus their outreach efforts for Medicaid education, said Roopa Foulger, OSF’s vice president of digital and innovation development, in a recent interview.
“Expansion alone is not enough,” she said. “How can we add other measures that solve for health literacy and some of the access barriers, including the digital divide? Expansion is the first step, but educational measures need to be put in place to really impact the population.”
Literacy is a major issue in underserved communities, another one of the study’s researchers pointed out. This is a key reason why Medicaid expansion didn’t have a huge impact on the state’s most vulnerable populations, said Laurence Weinzimmer, a professor and researcher at Bradley University.
When the researchers were conducting their surveys with Illinois residents, sometimes respondents couldn’t read the survey and needed someone to sit down with them and help. But that kind of help doesn’t always exist when someone is trying to enroll in Medicaid, Weinzimmer explained. Medicaid can expand further and further, but those efforts won’t be as impactful if Americans don’t understand the process or documentation, causing them to quickly give up on enrollment.
Weinzimmer pointed out another important aspect of the study. When asked “Why weren’t you able to receive care that you needed in the past year?” survey respondents’ top two answers were that they couldn’t afford it or didn’t have insurance.
“For those that don’t believe they can afford a copay, many are not aware that Medicaid is an option. I think that’s a huge challenge,” he declared.
To increase Medicaid education, Weinzimmer said healthcare providers should partner with organizations that people trust. In underserved communities, these organizations are often churches and other religious organizations. Communicating about Medicaid through a church can expose members of the community to opportunities to get healthcare that they might not otherwise be aware of, he explained.
Health navigators — people who help patients navigate their healthcare journey — are also important when it comes to strategies to increase Medicaid enrollment and utilization, Foulger said.
At OSF, health navigators are available from 8 a.m. to 8 p.m. seven days a week, she explained. People can call or text these navigators for any questions they have about where to seek care or how to pay for it. These navigators often help patients with things like choosing a primary care physician, arranging transportation to appointments and figuring out child care during times they need to receive medical services.
Photo: zimmytws, Getty Images