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NLM Director’s Comments Transcript
Update: Health Insurance’s Impact: 03/24/2014

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NLM Herb Garden purple and blue flowers.

Greetings from the National Library of Medicine and

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what's new this week in MedlinePlus.listen

A 2008 Medicaid lottery that provided health insurance to selected Oregon recipients comparatively resulted in some clinical benefits, increased use of some health services, and reduced  financial strain, finds the updated studies summarized on the website of the Oregon Health Insurance Experiment. The website can be found at:

The research stems from a rare opportunity to assess the impact after Medicaid (government supported health insurance) became available to some — but not all — randomly selected, low income Oregonians in 2008.
Some of the summarized research on the website tracks an array of clinical and other impacts among 6,387 adults who received expanded Medicaid coverage — compared to 5,842 adults, who were not selected by the Oregon lottery to receive health insurance. Some of the research focuses on the impact within the Medicaid recipient group.

Since the U.S. Affordable Care Act expands the availability of Medicaid and other health insurance plans to more Americans, Oregon’s experiences may be a preview of health insurance’s expansion in other states.

Specifically, one study found on the website reports the probability of diagnosis for diabetes and use of diabetes medications comparatively increased significantly among the adults who received Medicaid coverage. Oregon’s recent Medicaid recipients also experienced comparatively significantly reduced rates of observed and diagnosed depression.

In comparisons of post-lottery medical tests, the same study found no overall differences in blood pressure, cholesterol levels, and some blood sugar levels between the two groups.

A different study about the use of health services found the Medicaid recipients were 30 percent more likely to be admitted to hospital non-emergency departments and seven percent more likely to enter emergency rooms within the state’s hospitals. The likelihood that Medicaid recipients used outpatient care increased by 35 percent and their use of prescription medications increased by 15 percent.

A third study about the financial impact of receiving Medicaid coverage found the need to borrow money as well as to skip paying bills because of medical expenses fell by more than 50 percent.

Similarly, the study found the probability of having an unpaid medical bill sent to a collection agency fell by 25 percent among the randomly selected Medicaid recipients.

We will check in on the results from Oregon from time to time for three reasons.  First, as aforementioned, the Oregon experiment provides a preview of what might occur in other states where access to health insurance is increasing. Second, Oregon offers a pioneering assessment of the impact of expanded health insurance coverage on some clinical results, the consumer utilization of health care services, and some other personal influences on recipients. Third, it is refreshing to have access to evidence about health insurance’s impact for a change rather than surmise how it impacts recipients.

Meanwhile,’s Medicaid health topic page provides background information about this health insurance plan, which varies by state. A comparison of Medicaid plans by state (provided by the Centers for Medicare and Medicaid Services) is available in the ‘overviews’ section of’s Medicaid health topic page.

A website that provides succinct answers to frequently asked questions about Medicaid (from the Rural Assistance Center) is available in the ‘specific conditions’ section of’s Medicaid health topic page.’s Medicaid health topic page also contains an online database of insurance benefits (from the Henry J. Kaiser Family Foundation) within the ‘Directories’ section.

From the Medicaid health topic page, you can sign up to receive email updates with links to new information as it becomes available on MedlinePlus.

To find’s Medicaid health topic page, just type ‘Medicaid’ in the search box at the top of’s home page. Then, click on ‘Medicaid (National Library of Medicine).’ also has health topic pages devoted to health insurance and Medicare.

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It was nice to be with you. I look forward to meeting you here next week.