Concerns Over Medicaid Cuts Based on Questionable Research

The recent budget settlement bill, signed under President Trump, could lead to significant Medicaid cuts, impacting millions of low-income Americans. This appears to be largely influenced by research that has been criticized as flawed and misleading.

The bill suggests that it will crack down on “fraud and abuse,” yet this might significantly diminish essential health services for at least 12 million individuals. The requirements it sets could be unrealistic, with costs deemed affordable only in theory, and access to medical facilities, such as hospitals and nursing homes, being quite limited.

There’s a troubling implication here—potentially causing, I think, thousands of unnecessary deaths and a rise in preventable hospitalizations among those losing their insurance coverage.

What seems to have gone relatively unnoticed during the discussions around this bill is the reliance on unreliable Medicaid studies. One particular study touted by the Trump administration, along with some Republican leaders and the media, claimed that Medicaid coverage showed no tangible improvement in physical health outcomes.

But it’s crucial to mention that this study—the Oregon Health Insurance Experiment from several years ago—was oversimplified and didn’t inform policymakers effectively. It’s important to note that over two-thirds of the individuals considered in that study were, in fact, not enrolled in Medicaid.

The study’s conclusions lack scientific merit, especially when justifying such sweeping Medicaid changes. It claimed that the expansion of Oregon’s Medicaid did not enhance the physical health of those covered, a conclusion possibly motivated by the ideologies opposing the program’s expansion.

This Oregon study has been referenced by various organizations and media outlets as a foundation for proposed Medicaid cuts. Yet, it’s worth noting that the study doesn’t hold up under scrutiny—far from it, actually. It was based on a supposed random lottery system to assign Medicaid eligibility, which, in theory, could have worked, but the reality was different.

A surprising fact tucked away in the study’s appendices shows that 70% of those assigned to Medicaid weren’t actually eligible. They either made too much money or didn’t complete the necessary paperwork accurately. Yet, the authors misleadingly labeled these individuals as “recipients of Medicaid,” which is, frankly, quite confusing—almost like a drug trial where a significant number didn’t actually receive the treatment.

There’s no shortage of evidence indicating that Medicaid coverage is vital for low-income and chronically ill individuals. For example, a landmark study outlined how life-threatening illnesses actually escalated when Medicaid was cut for low-income individuals in California.

When coverage is reduced, such as for diabetes or mental health conditions, it could lead to losing essential medications and ultimately result in costly emergency visits and institutional care that far outweigh any savings. This can create a vicious cycle of worsening health conditions.

Errors in scientific research can have long-lasting damaging impacts on public health. Flawed studies like this have been cited extensively across numerous media platforms, often serving as justifications for slashing Medicaid support for vulnerable populations. It’s alarming to consider just how much this misinformation could harm many individuals.

Ultimately, it is vital to recognize that the assumptions made by the Trump administration, several media voices, and architects behind Project 2025 are built on shaky ground.

—Stephen Soumerai and Gordon Moore, Harvard Medical School Professors