The dirtiest little secret of the RepublicansObamacare repeal campaign is that its genesis has nothing to do with the Affordable Care Act as such, but with a long-cherished desire to gut Medicaid, which predated the ACA by nearly a half-century.

To advance this goal, conservatives and GOP leaders have asserted consistently that Medicaid doesn’t work or even “harms its beneficiaries.” Health economist Austin Frakt of Veterans Affairs and Boston University now has done Medicaid’s defenders an important service by issuing a call to collect in one place all the claims that the program is broken or harmful, and then pointing us to research debunking those smears.

To be fair, the goal of gutting Medicaid as part of Obamacare repeal isn’t really much of a secret. House Speaker Paul Ryan, R-Wisc., gave the game away in a videotaped discussion with National Review’s Rich Lowry in March. There he confessed, “So Medicaid, sending it back to the states, capping its growth rate, we’ve been dreaming of this since I’ve been around — since you and I were drinking at a keg…. I’ve been thinking about this stuff for a long time.”

Ryan is 47 now, so he would have been dreaming about cutting Medicaid in the early 1990s while “drinking at a keg,” perhaps at frat parties at his alma mater, Miami University of Ohio. The ACA was enacted in 2010.

The best-known study of the effect of Medicaid coverage is the so-called Oregon Experiment, which has the best pedigree of all such studies: It was done by researchers at Harvard and MIT, including such supporters of universal healthcare as Jonathan Gruber. Medicaid critics constantly cite it as proof that having Medicaid coverage is “no better than being uninsured,” to quote Avik Roy.

The problem here is that the authors of the study disagree with that. The study, which followed newly enrolled Medicaid patients for two years, found no improvement in three markers associated with cardiac health and diabetes: cholesterol, high blood pressure and blood sugar levels. But the figures for those were not statistically significant, which makes them useless for assessing the program’s effects.

The researchers did, however, find a statistically significant reduction in the incidence of depression, a significant increase in the diagnosis of diabetes and the use of diabetes medications, and in cholesterol screening, pap smears, mammograms and other screening tests. They also found a significant “reduction in financial strain from medical costs.” Catastrophic expenses, defined as those exceeding 30% of income, were “nearly eliminated.”

These benefits can be traced directly to Medicaid coverage, and they’re not trivial. The fact that Medicaid’s critics return to the Oregon results over and over, cherry pick a few findings, and misinterpret those should tell you something. It’s that declaring Medicaid to be useless, or no better or even worse than having no insurance at all is merely a shibboleth.

It’s an incantation that gets endlessly repeated as truth, even though empirical studies show that there’s no truth in it at all. Verma, by citing both the Virginia and the Oregon studies in her op-ed without acknowledging their limitations, turned in a shameful performance.

The congressional Republicans backing the Obamacare repeal bills that cut the meat and bones out of Medicaid to the tune of $800 billion to $1 trillion, must have some ulterior motivation. It can’t be improving its users’ health, because what they’re planning would achieve just the opposite. What could it be?

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Republicans say Medicaid doesn’t work, so it should be cut. Here are all the ways they’re wrong