Why Medicaid Beats Private Health Plans in Member Satisfaction

Written by:
David Moser
April 18, 2022

It doesn’t take an Elon Musk or Jeff Bezos to see why transitioning eligible workers from the group plan to Medicaid makes business sense. But you might wonder: Will they want to switch? 

Most will, according to an October 2021 Insure.com survey. The third-party insurance marketplace found that 79% of Medicaid enrollees give their plan high marks, compared to 73% of those with individual plans and 70% of those with employer-sponsored plans.

Not surprisingly, Medicaid ranked highest among plan types for costs and deductibles. But as anyone who’s dealt with insurance knows, there’s a lot more to the story than that.

Lower Costs, Better Care

Health insurance is more than a financial decision; it’s a life decision. Neither you nor anyone else can force Medicaid-eligible team members to enroll.

The good news is, Medicaid makes its own case. It outranked individual and employer plans in every category Insure.com considered.

Let’s start with the breadth of services. 45% percent of Medicaid enrollees gave their plan five stars in this category, while just 30% of those on individual plans and 37% on employer plans did.

Why? Because unlike most commercial plans, Medicaid usually includes dental, vision, and hearing coverage. It pays for long-term care, hospice expenses, and transportation to healthcare appointments — all unusual or expensive coverages in commercial plans.

Also read: You Can Help Every Worker Feel Grateful for Good Healthcare Insurance

The story is similar with provider networks. Despite supposed shortages of providers who take Medicaid, 47% of Medicaid enrollees — compared to 40% for employer plans and 35% for individual plans — give their network five stars. 

The reason is, the Centers for Medicare & Medicaid Services is the nation’s single largest payer for healthcare. More than 77.8 million Americans are enrolled in Medicaid, plus another 6.9 million children who get care through CHIP. Every provider wants to do business with the largest payer. 

What about satisfaction with claims? In this category, Medicaid wallops commercial plans. 51% percent of Medicaid enrollees awarded it five stars for paying claims; among those enrolled in individual and employer plans, just 31% and 33%, respectively, gave as high a rating.

Remember, private insurance companies make more money the more claims they deny. Medicaid doesn’t exist to make a profit, so it has little or no motivation to deny claims.

‘Public’ Isn’t Pejorative

Another observation you might make about the study is that Medicare — both Advantage and the original — also beat private plans in member satisfaction. Both versions are rated highly by 78% of enrollees, just one percentage point less than Medicaid.

Many assume that because commercial plans are privately administered and paid for, they must be preferable to public insurance programs. But the data are clear: Government health insurance programs work as well or even better than private ones.

You’re not an Ebenezer Scrooge for offering eligible employees great coverage that can, if they switch, reduce your company’s plan costs. In fact, you’re a better leader — of people, and of a business — because of it.