When Tennessee abruptly disenrolled around 200,000 people from medicaid in 2005 — one of the most sweeping state-level Medicaid drop-offs in U.S. history — the crime rate increased, a new study supported by the National Institutes of Health found.
The study, released as a working paper in March by four scholars who study public health, comes at a time when many states are ramping up punishment in response to crime, while leaving public services largely underfunded, Bolts reports.
In an interview, Catherine Maclean, a professor of public policy at George Mason University and one of the authors of the study, said that the findings indicate that when states cut Medicaid to save some money on health care, it may ultimately end up costing more in terms of the impacts on public safety.
“You can think about it as the value of the social safety net, providing support for people who don’t have much,” she said. “It doesn’t just impact those people. It impacts society.”
These patterns now risk repeating themselves at a large scale. Just last year, every state in the U.S. experienced a major contraction in Medicaid coverage, as the federal government ended an emergency pandemic policy that had kept millions enrolled in the program. States are still feeling the effects of that decision, as Bolts recently detailed.
Maclean said that an increase in theft was one of the driving factors in the overall increase in crime, which indicated to her that the broader financial instability that comes losing health insurance might drive more people to more desperate measure.
“When we broke these crimes out, we see that our findings for non-violent crime were really driven by theft,” she said. “That, to me, suggested that some of these crimes we see might be financially motivated, which might be due to the loss of resources that one experiences when Medicaid is removed, or it could be increased need to finance medical bills.”
She also noted that treatment for behavioral health and addiction services is often paid for by medicaid, and that a reduction in access to those services could lead to an increase in crime.
“Medicaid is the largest purchaser of behavioral health care services in the country, so it plays a really important role of connecting people to services. I’m not trying to say that every crime is related to behavioral health, to substance use, because I don’t think that’s true, but I think it could be a bit short-sighted for policymakers not to consider those linkages.”