A spillover effect: Medicaid expansion leads to healthier dietary
choices

Date:
September 8, 2020
Source:
University of Connecticut
Summary:
Besides providing health care to millions, the Medicaid program
helps recipients make healthier food choices, according to new work.



FULL STORY ========================================================================== Besides providing healthcare to millions, Medicaid helps recipients
make healthier food choices according to UConn research published in the journal Health Economics. UConn Professor of Agricultural and Resource Economics, Rigoberto Lopez, Rebecca Boehm now an economist with the Union
of Concerned Scientists, and Xi He now a post-doctoral researcher at
the Iowa State were interested in investigating the impact of Medicaid
on food choices.


========================================================================== Medicaid is beneficial to recipients in a multitude of ways, by reducing emergency room visits, increasing access to preventive healthcare,
while reducing out-of-pocket medical costs and debt, for instance. The
program is highly politicized and is met with criticism and assumptions
that it is too costly, yet research has shown the program actually saves
states money.

He, Lopez, and Boehm were interested in looking at other potential
benefits of the program and also hoped to bridge some gaps in the
literature says He, "There are many studies about the impact of Medicaid
on mental health or on health spending but few studies have looked
at how Medicaid affects food choices." He explains that by virtue of
spending less on healthcare, new Medicaid recipients would have more
room in their budget for food and therefore may spend more money on the
same unhealthy foods and beverages they have always purchased. On the
other hand, with more access to healthcare and health education through
contact with providers, the researchers surmised that purchasing patterns
could improve, says He.

To see if this was the case, the researchers looked at purchases
of beverages such as carbonated soft drinks, juice, milk and other non-alcoholic beverages before and after the expansion of Medicaid and
compared purchases in states that did and did not expand the program
under the Affordable Care Act. In a way, the states that did not expand Medicaid were the control group for their study. They also compared
purchase preferences for sugar content of these beverages.



==========================================================================
"We found that households in expansion states significantly increased
their purchase of diet soda and bottled water, but there was no change
in purchase of regular soda. But overall, these results indicate that
Medicaid expansion, in states that did expand, shifted people's purchases
to products with less sugar," says He.

Access to healthcare has wide-ranging positive effects on the lives and
habits of recipients. The added benefit of knowledge resulting from access
to healthcare is not a policy mechanism that is usually discussed says
Boehm, "With so many people working to help people eat healthier and
to reduce obesity in the US, I don't hear a lot of talk about how the
provision of healthcare through this income effect we proposed in this
study can help people eat and drink healthier." Lopez says programs
like Medicaid are often unfairly attacked and those attacks are done so
without the numbers and data, therefore it is vital that research like
this reaches decision makers.

"Besides the obvious benefit of subsidized healthcare, there is an
additional spillover of the program in promoting a healthy diet by
reducing one of the three evils of the American diet -- sugar -- which
is bad in all respects from calories to cancer to obesity. The program contributes not just to cover the treatment of patients but also in a
more preventive way," says Lopez.

The researchers add that now with the pandemic, prevention and access
to healthcare is more vital than ever. This is especially true for
those with pre- existing conditions and conditions that put people at
an increased risk for corona virus, such as obesity.

Continued research on the implications of programs such as Medicaid are
needed, says Lopez, who says policy decisions need to be made based on research, not politics.

"It's important to see if we spend this money on Medicaid, we're getting
some of it back even if it's indirect," says Boehm. "Policy makers need
to have this information. Not all states expanded Medicaid under the
ACA, so if we have these results saying we see diet quality benefits
that may help push other states to join the expansion.


========================================================================== Story Source: Materials provided by University_of_Connecticut. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Xi He, Rigoberto A. Lopez, Rebecca Boehm. Medicaid expansion and
non‐alcoholic beverage choices by low‐income households.

Health Economics, 2020; DOI: 10.1002/hec.4133 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/09/200908131104.htm

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