Only 30% of Medicaid recipients rate their health positively
Medicaid recipients more likely than others to be obese, smoke
U.S. adults who receive their healthcare coverage through Medicaid are
in worse health than those with other forms of health insurance. Three
in 10 adults covered by Medicaid describe their health as " excellent"
or "very good," compared with 59% of those receiving employer-
or union-based insurance and 51% receiving military or veteran's health
insurance. Even the uninsured (33%) and adults covered by Medicare (40%)
-- which predominantly insures adults aged 65 and older -- are more likely
than Medicaid recipients to rate their health positively.
U.S. Adults' Reports of Their Own Health, by Insurance Source
Would you say your own health, in general, is …
Medicaid
Uninsured
Medicare
Military or veteran's
Employer or union
Something else
%
%
%
%
%
%
Excellent/Very good
30
33
40
51
59
52
Fair/Poor
40
31
31
21
11
18
Gallup-Sharecare Well-Being Index
These results are based on 147,465 interviews conducted among U.S. adults
aged 18 and older Jan. 2-Nov. 5, 2017, as part of the Gallup-Sharecare
Well-Being Index. Currently,
9.3% of U.S. adults younger than 65 receive their coverage through Medicaid.
One reason that Medicaid recipients may be less likely to report being
in good health is that the system is designed for individuals with disabilities
and those in lower-income households who cannot obtain health insurance
elsewhere. According to Gallup/Sharecare data, 63% of those insured by
Medicaid report a household income of less than $36,000 annually. Gallup
research has found a
link between poverty and poor health -- including much higher rates of physical and emotional health problems.
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Medicaid Population Plagued by Chronic Health Conditions
Among adults not covered by Medicare, Medicaid recipients report the highest
incidence of chronic health conditions compared with all other groups.
Over a third of adults on Medicaid are obese (36%), and a quarter say
they suffer from depression -- the highest among all insurance groups.
Additionally, Medicaid recipients (17%) are significantly more likely
to have high cholesterol, trailing only those on Medicare (34%) and on
par with those who have military or veteran's insurance (17%).
The uninsured are the least likely to report having high blood pressure
(12%), high cholesterol (7%) or cancer (1%), likely due in part to their
younger average age relative to the other insurance groups and the fact
that they are not being diagnosed as part of regular medical treatment.
Almost a third of uninsured adults (31%) are younger than 30, compared
with 20% of adults with some form of health insurance coverage. Eight
percent of uninsured adults report being depressed, on par with 7% of
those with employer- or union-based coverage who say the same -- the lowest
of all groups.
Although fewer uninsured adults have been diagnosed with most chronic health
conditions, just 33% report having excellent or very good health, with
only Medicaid recipients rating their health worse. This may be because
those without health insurance are less likely to afford doctor visits
and are thus less likely to be diagnosed with and treated for chronic diseases.
U.S. Adults' Self-Reported Health Conditions, by Insurance Source
Uninsured
Employer or union
Medicare
Medicaid
Military or veteran's
Something else
%
%
%
%
%
%
High blood pressure
12
18
47
26
24
16
High cholesterol
7
12
34
17
17
11
Depression
8
7
16
25
14
10
Cancer
1
1
4
3
3
1
Obese
30
28
30
36
27
23
Gallup-Sharecare Well-Being Index
The Medicare population -- those aged 65 and older -- are the most likely
of all insurance groups to report having high blood pressure (47%) and
high cholesterol (34%) -- both conditions for which advanced age is a
particularly strong risk factor.
Medicaid Population Most Likely to Smoke
One reason that preventable chronic conditions plague the Medicaid population
may be that they are much more likely than other groups to smoke. Over
a third of Medicaid recipients (36%) say they smoke, compared with less
than a fifth of those in other insurance groups. About three in 10 uninsured
adults (31%) say they smoke.
Health-Related Behaviors, by Insurance Source
Uninsured
Employer or union
Medicare
Medicaid
Military or veteran's
Something else
%
%
%
%
%
%
Smoke
31
13
16
36
19
15
Exercise frequently
45
43
49
47
38
42
Eat fruits and vegetables frequently
49
41
36
43
40
42
Eat healthy
60
59
78
59
65
61
Gallup-Sharecare Well-Being Index
Medicaid recipients are roughly on par with most other insurance groups
in their self-reported healthy eating, frequent produce consumption and
frequent exercise habits. The uninsured population is the most likely
to say they frequently consume fruits and vegetables, while Medicare recipients
are the most likely to say they eat healthy.
Implications
Americans spend over $3 trillion each year on medical care -- about $9,000
per person -- making the U.S. an outlier even among other high-income
countries. Despite spending the most on healthcare, the U.S. does not
boast the best health-related outcomes. For example, the U.K. spends about
$5,000 less per person on healthcare than the U.S. but has a higher average
life expectancy and a lower infant mortality rate. Relative to other high-income
countries, the U.S. ranks poorly on obesity, life expectancy and other
chronic health conditions.
This new analysis suggests that focusing on preventive care for Medicaid
patients may help them avoid chronic conditions before they start. The
Medicaid population is about twice as likely as other insured adults to
smoke and is more likely than all other insured adults -- as well as the
uninsured -- to be obese. Working to reduce unhealthy habits that lead
to chronic conditions can improve the health of Medicaid recipients while
also decreasing program costs.
Survey Methods
Results are based on telephone interviews conducted Jan. 2-Nov. 5, 2017,
as part of the Gallup-Sharecare Well-Being Index survey, with a random
sample of 147,465 adults, aged 18 and older, living in all 50 U.S. states
and the District of Columbia. For results based on the total sample of
national adults, the margin of sampling error is ±1.0 percentage
points at the 95% confidence level. For results based on the total sample
of 7,457 Medicaid recipients, the margin of sampling error is ±1.6
percentage points at the 95% confidence level. For results based on the
total sample of 12,778 uninsured adults, the margin of sampling error
is ±1.0 percentage points at the 95% confidence level. All reported
margins of sampling error include computed design effects for weighting.
Each sample of national adults includes a minimum quota of 70% cellphone
respondents and 30% landline respondents, with additional minimum quotas
by time zone within region. Landline and cellular telephone numbers are
selected using random-digit-dial methods.
