Medicaid patients struggle most with preventable chronic illnesses

April 09, 2013 at 02:26 PM
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U.S. adults whose primary health insurance source is Medicaid are in significantly worse health than those with employer-sponsored coverage — and it's mainly preventable.

A third of Medicaid patients are obese (34 percent) while another 22 percent are being treated for depression and 24 percent are being treated for high blood pressure, according to the latest Gallup-Healthways Well Being Index. Medicaid patients are also more likely suffer from diabetes and asthma.

The research comes just as the Medicaid population is set to grow because of the program's expansion under the Patient Protection and Affordable Care Act (PPACA). The Department of Health and Human Services recently issued a final rule guaranteeing 100 percent funding for new Medicaid beneficiaries as part of the health reform law.

Gallup's findings aren't particularly surprising — there has long been a link between poverty and poor health — but the numbers underscore the vast challenges and costs ahead for an expanded Medicaid. The data is based on more than 28,000 interviews conducted as part of the Gallup-Healthways Well-Being Index with adults aged 18 and older between Jan. 3-March 1.

Preventable illnesses are a major cost burden that many insurers and employers have been working to eradicate through initiatives such as wellness programs. The research suggests that chronic conditions will become an even greater burden for Medicaid, because of health reform's goal to expand the program. Addressing these illnesses before they become serious, especially among the vulnerable low-income population, would help to significantly bring down Medicaid costs, researchers suggest.

Smoking is the worst health habit for Medicaid patients, Gallup found. More than a third of Medicaid patients (36 percent) say they smoke — making them 21 percentage points more likely to report the habit than those with employer-based insurance.

Those on Medicare also suffer from poorer health, but that's generally due to the older age of Medicare recipients. Those on Medicare are most likely to have high blood-pressure, high cholesterol, diabetes, and to have had a heart attack.

Gallup estimates that 4.5 percent of Americans aged 18 and older have Medicaid as their primary source of health insurance, while 18 percent mainly rely on Medicare, 3.6 percent on a military or veteran plan and 44.5 percent on an employer plan.

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