No, Obamacare didn’t magically make young people healthier

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They were anticipating this like their lives depended on it. Democrats and the media breathlessly reported Wednesday morning that a study found that “young adults” are healthier after the passage of Obamacare:

Starting in 2010, the Affordable Care Act allowed adults under age 26 to remain on their parents’ health plans, the first coverage expansion to take effect under the law.

Previous surveys have indicated that this provision, which remains among the law’s most popular, allowed millions of young adults to get health insurance over the last several years.

The new study, published in the Journal of the American Medical Assn., suggests the coverage expansion also measurably increased the number of young adults who reported that they are in excellent physical and mental health.

Researchers also found a significant drop in how much young people were paying out of pocket for their medical care after the law went into effect.

Great news! Problem solved! Crisis averted! Let’s pass another one! Except under further scrutiny, nearly every claim being extrapolated from this study is wrong.

Here is the actual data collected:

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The survey collected responses from two groups twice: young adults (19-25) and other adults (26-34) each before Obamacare and after. Both groups were asked if they had health insurance, which medical services they used, and to rate their physical and mental health.

The first problem is that we’re judging the actual success of a law by the results of a poll, with all of the uncertainty that those statistical models produce. The story, study, and survey don’t even bother to mention the margin of error, and given that most of the relevant differences in pre- and post-Obamacare responses are under 5%, it isn’t even certain if the results are statistically significant in the first place. The study calculates a P-value of statistical significance for the responses, but that treats them as conclusive data instead of error-prone survey results. It’s only after we sweep the statistical questions under the rug that we discover the real problems with the narrative being built around this information, and it appears on several levels.

The young adult group reports a 6.5% increase in the number of insured among that population. The study and survey report this increase as a result of the “parents’ insurance” coverage increase under Obamacare. However, no information is given as to whether this new 6.5% were actually covered under their parents insurance or got their own. Either way, the result is a net positive if your concern is the number of people with insurance. But the next problem raises the question of whether that even matters.

While young adults reported they had excellent health more after Obamacare than before, 4% more (not 14% as reported in the LA Times story, which is the proportional increase, not overall) for physical and 2.5% more for mental health, they reported almost the exact same amount or fewer (!) health services used. The number who said they had an outpatient medical visit went down 0.8%, doctor visits went down 0.2%, emergency room visits were identical, hospitalization went down 0.3%, and the use of prescriptions went down 0.9%. Young adults got more health insurance, received the same amount of medical care, but still got healthier. MAGIC!

These befuddling findings suggest that health insurance doesn’t actually make people healthier, but act as a placebo to make people think they’re healthier. This hypothesis is also corroborated by a landmark study of Medicaid use in Oregon. When the state found extra money to increase their Medicaid enrollment in 2008, a group of doctors decided to track several thousand new enrollees and compare their physical health, mental health, and finances after two years to several thousand who applied but were not enrolled in Medicaid. After two years, the Medicaid recipients had not improved their physical health, but had slightly better mental health, and had reduced their expenses for medical care compared to the non-Medicaid participants.

If that study is representative of all Medicaid use, we can conclude that the absurdly expensive program frought with waste, fraud, and abuse makes people feel better and saves them money, but doesn’t make them healthier, just like Obamacare’s young adult coverage expansion. And given the constantly increasing cost estimates of various parts of Obamacare, is it really worth ever more billions in taxpayer dollars just to make people feel like they’re healthier?


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