Health care utilization: the effect of extending insurance to adults on Medicaid or uninsured.

Current health care system reform proposals center on reducing the number of uninsured by extending private health insurance coverage. Discussion has also included enrolling Medicaid recipients in private programs. Much of the deliberation concerning extending coverage has centered on cost, but largely has not addressed the implications for health care utilization by these groups. If private insurance is extended to those currently uninsured as well as the Medicaid population, what impact will it have on utilization? Using data from the 1987 National Medical Expenditure Survey, the results of this analysis show that utilization would increase for the uninsured if private insurance benefits were extended, whereas utilization would decrease for those with Medicaid, however, the magnitude of the increase depends on the type of care.