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Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low-Income Children

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  • David Card

    (University of California at Berkeley)

  • Lara D. Shore-Sheppard

    (Williams College)

Abstract

Despite intensive scrutiny, the effects of Medicaid expansions on the health insurance status of low-income children remain controversial. We reexamine the effects of the two largest federally mandated expansions which offered Medicaid coverage to low-income children in specific age ranges and birth cohorts. We use a regression discontinuity approach, comparing Medicaid enrollment, private insurance coverage, and overall insurance coverage on either side of the age limits of the laws. We conclude that the modest impacts of the expansions on health insurance coverage arose because of very low takeup rates of the newly available coverage, rather than from crowdout of private insurance coverage. © 2004 President and Fellows of Harvard College and the Massachusetts Institute of Technology.

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Bibliographic Info

Article provided by MIT Press in its journal Review of Economics and Statistics.

Volume (Year): 86 (2004)
Issue (Month): 3 (August)
Pages: 752-766

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Handle: RePEc:tpr:restat:v:86:y:2004:i:3:p:752-766

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  1. Cutler, David M & Gruber, Jonathan, 1996. "Does Public Insurance Crowd Out Private Insurance?," The Quarterly Journal of Economics, MIT Press, vol. 111(2), pages 391-430, May.
  2. Joshua Angrist & Alan Krueger, 1998. "Empirical Strategies in Labor Economics," Working Papers 780, Princeton University, Department of Economics, Industrial Relations Section..
  3. John C. Ham & Lara D. Shore-Sheppard, 2001. "The Effect of Medicaid Expansions for Low-Income Children on Medicaid Participation and Insurance Coverage: Evidence from the SIPP," NBER Working Papers 8063, National Bureau of Economic Research, Inc.
  4. Pischke, J., 1992. "Individual Income, Incomplete Information, and Aggregate Consumption," Discussion Paper 1992-38, Tilburg University, Center for Economic Research.
  5. Currie, Janet & Gruber, Jonathan, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, MIT Press, vol. 111(2), pages 431-66, May.
  6. Esel Y. Yazici & Robert Kaestner, 1998. "Medicaid Expansions and The Crowding Out of Private Health Insurance," NBER Working Papers 6527, National Bureau of Economic Research, Inc.
  7. Blumberg, Linda J. & Dubay, Lisa & Norton, Stephen A., 2000. "Did the Medicaid expansions for children displace private insurance? An analysis using the SIPP," Journal of Health Economics, Elsevier, vol. 19(1), pages 33-60, January.
  8. David Card & Lara Dawn Shore-Sheppard, 2001. "Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions," JCPR Working Papers 248, Northwestern University/University of Chicago Joint Center for Poverty Research.
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