Medicaid Is Failing the People It Is Intended to Help

Donald Schneider /

Heritage’s Kevin Dayaratna finds in a recent survey of academic literature that “Medicaid’s so-called safety net cripples the very people it is designed to help.”

The structural flaws in the program produce a cascade of failures, starting with underpaid and overburdened doctors, which produces longer waits for care, in turn leading to late-stage diagnosis of illnesses, finally resulting in more costly (though often less effective) treatments and higher mortality rates.

Recent statistics show that Medicaid enrollment has reached an all-time high of 70.4 million beneficiaries. In other words, one in five Americans now receives Medicaid benefits. Despite this, Obamacare’s intended expansion of Medicaid would add another 17 million beneficiaries to the already overburdened program.

With this in mind, the failures of Medicaid must be acknowledged:

Dayaratna explains that “one of Obamacare’s greatest pretenses is that it improves access to health care. The new law attempts to achieve this goal by dumping millions more into the broken Medicaid system.”

A far better alternative is for policymakers to take the opposite approach of “mainstreaming” Medicaid beneficiaries into superior private insurance. Dayaratna points to the example of Florida’s successful five-county pilot program that gives Medicaid patients a choice of private managed care plans. Florida’s program has achieved “greater access to care, higher degrees of patient satisfaction, and a marked improvement in health outcomes” while also saving the state just under $120 million annually.

The Heritage Foundation’s Saving the American Dream proposal expands on that approach. It recommends transitioning non-disabled Medicaid beneficiaries into private health insurance and then better meeting the needs of the remaining (disabled and frail elderly) Medicaid population by integrating private, patient-centered care models into Medicaid.

Donald Schneider is currently a member of the Young Leaders Program at The Heritage Foundation. For more information on interning at Heritage, please visit: