Whether through Medicaid or private insurance, having coverage is consistently tied to improved medical care access

For decades, Medicaid has provided virtually no-cost coverage to millions of Americans priced out of the private insurance market. Still, state legislators, policy analysts, and the popular press continue to question Medicaid’s value, particularly in relation to private coverage. Twelve states have not expanded Medicaid coverage under the Affordable Care Act (ACA) framework despite the offer of federal funding to cover 90 percent of the costs associated with the additional enrollees. Other states have experimented with reforms that make the Medicaid program function more similarly to private insurance, including requiring enrollees to pay premiums to enroll and pay cost sharing to seek care. By contrast, some policymakers in other states are considering establishing a Medicaid buy-in as a public option for health insurance, which would effectively expand Medicaid coverage beyond the ACA expansion population. Behind these very different policy directions are enduring empirical questions about the quality of the coverage Medicaid provides. The public and scholars alike remain unsettled on whether Medicaid adequately delivers needed medical care for its low-income beneficiaries; whether such care is on par with that accessed through private insurance; and whether, as some have argued, Medicaid is even worse than having no coverage at all. Our Policies for Action project examines these questions directly. Are beneficiaries with Medicaid getting to the doctor when they need to? Or are they less able to access care than they would be with private coverage? (author introduction)