Medicaid expansion supported in ND

The Governor of North Dakota, Jack Dalrymple, did include Medicaid Expansion in his budget and NDESPA applauds him for it.  We also applaud the ND House of Representatives for passing Medicaid Expansion by a vote of 57-36. The bill now goes to the Senate for consideration.

The Advisory Board Company's overview of where each state stands on Medicaid Expansion indicates confidence that ND will participate.

North Dakota*: Gov. Jack Dalrymple (R) in January said the politics associated with the ACA should not prevent North Dakota from participating in the Medicaid expansion. He is supporting a bill that would allow the state health department to access federal funds allocated through the ACA. Dalrymple also said he will include the expansion in his budget proposal and that members of his staff will testify in favor of the expansion before state lawmakers (Jerke, Grand Forks Herald, 1/12).

Representives opposed to Medicaid expansion introduced a separate bill HB 1362 that separates funding for Medicaid expansion to a stand-alone bill.

When HB 1362 had a public hearing, the support far out numbered the opposition. 
 
Testimony by the North Dakota Department of Human Services highlighted the benefits expansion would provide North Dakotans. 

More than 23 groups are on record as in favor of Medicaid Expansion.

Kaiser Family Foundation's Fact Sheet on Medicaid Expansion skillfully explains the ins and outs of the opportunity.   

AARP North Dakota submitted an op ed on Medicaid expansion makes the case for ND to embrace the program.  

The Governor needs citizen support to move the effort through a reluctant legislature. The research is clear, Medicaid expansion is a smart and effective opportunity which North Dakota should not pass up.
  
The Oregon Health Insurance Experiment: Evidence from the First Year

Amy Finkelstein, Sarah Taubman, Bill Wright, Mira Bernstein, Jonathan Gruber, Joseph P. Newhouse, Heidi Allen, Katherine Baicker, and The Oregon Health Study Group NBER Working Paper No. 17190, July 2011, JEL No. H51,H75,I1

NPR coverage on study results and the study results:

ABSTRACT

In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides a unique opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group.

Some key statements from the paper:

“Our estimates of the impact of public health insurance apply to able-bodied uninsured adults below 100 percent of poverty who express interest in insurance coverage.”

“...our results are specific to a population of low-income, uninsured adults in Oregon who expressed interest in obtaining health insurance (by signing up for the lottery). This group is not representative of the low-income uninsured adults in the rest of the United States on a number of observable (and presumably unobservable) dimensions. One striking difference is that our study population has more whites and fewer African-Americans (by about 15 percentage points each) than the general low-income, uninsured adult, US population. It is also somewhat (4 to 5 years) older and on some measures appears to be in somewhat worse self-reported health (Allen et al. 2010).”

“...have substantial and statistically significantly higher health care utilization, lower out-of-pocket medical expenditures and medical debt, and better self-reported health than the control group that was not given the opportunity to apply for Medicaid.”

“...(25 percent) decline in the probability of having an unpaid medical bill sent to a collection agency and a 20 percentage point (35 percent) decline in having any out-of-pocket medical expenditures.”