Changes in Health and Ability to Work Among Medicaid Expansion Enrollees: a Mixed Methods Study

Area of Science:

• Health Services Research
• Public Health Policy
• Health Economics

Background:

• Michigan expanded Medicaid via the Affordable Care Act, establishing the Healthy Michigan Plan (HMP).
• The HMP aimed to enhance health outcomes for low-income residents and stimulate the state's economy.
• This study investigates the multifaceted impacts of the HMP on its enrollees.

Purpose of the Study:

• To evaluate the Healthy Michigan Plan's effect on enrollees' health status.
• To assess the HMP's influence on participants' capacity to work and seek employment.
• To understand the relationship between improved health and employment-related outcomes.

Main Methods:

• A mixed-methods approach was employed, combining qualitative interviews and quantitative surveys.
• Data were collected from 67 qualitative interviews and 4090 computer-assisted telephone surveys (53.7% response rate).
• Participants were non-elderly adult enrollees of the Healthy Michigan Plan.

Main Results:

• Nearly half of respondents reported improvements in physical (47.8%), mental (38.2%), and dental (39.5%) health post-HMP enrollment.
• A significant majority of employed respondents (69.4%) and job-seeking respondents (54.5%) indicated the HMP aided their work performance and job search efforts.
• Improved health was strongly associated with enhanced ability to perform work, seek employment, and secure better jobs, though not directly with employment status.

Conclusions:

• The Healthy Michigan Plan has positively impacted the health and employment-related capabilities of low-income residents.
• Medicaid expansion through the HMP has demonstrably improved enrollees' physical, mental, and dental health.
• Enrollees reported that better health facilitated their ability to work and find employment, despite persistent barriers like age, disability, and caregiving responsibilities.