AbstractThis paper uses the National Survey of America's Families (NSAF) to examine whether the low take-up rate for publicly provided health insurance is caused by welfare stigma that people associate with those programs. The NSAF asks several questions related to welfare stigma, including whether respondents believe that welfare makes people work less, or whether welfare helps people get back "on their feet." If stigma plays a role in take-up, then among eligible patients, those who neglect to enroll in Medicaid will have more negative attitudes towards welfare, all else equal. As a second approach, we test the predictions of a Moffitt (1983) utility function, with fixed and variable stigma from public benefits. In the end, we believe we can demonstrate that stigma plays a large and statistically significant role in deterring Medicaid take-up, but we cannot distinguish responses to Medicaid benefits (which should have no variable stigma) from responses to Food Stamps (which should have large variable stigma). Finally, the results of this research, while of academic interest in their own right, also have substantial policy implications. If low Medicaid take-up is caused by welfare stigma, the policy prescription is much different than if low take-up is caused by paperwork hassles, lack of information, or perceived low quality of care.
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Bibliographic InfoPaper provided by Georgetown University, Department of Economics in its series Working Papers with number gueconwpa~04-04-06.
Date of creation: 06 Apr 2004
Date of revision:
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Postal: Georgetown University Department of Economics Washington, DC 20057-1036
Web page: http://econ.georgetown.edu/
Postal: Marcia Suss Administrative Officer Georgetown University Department of Economics Washington, DC 20057-1036
Find related papers by JEL classification:
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
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- Moffitt, Robert, 1983. "An Economic Model of Welfare Stigma," American Economic Review, American Economic Association, vol. 73(5), pages 1023-35, December.
- Sean Orzol, 2013. "Proven Strategies for Missouri Health Care Covergage: Program Outreach and Enrollment," Mathematica Policy Research Reports 7810, Mathematica Policy Research.
- Ewoudou, Jacques & Tsimpo, Clarence & Wodon, Quentin, 2009. "Stigma and the take-up of social programs," Policy Research Working Paper Series 4962, The World Bank.
- Sean Orzol & Linda Barterian & Michael Barna, 2012. "Proven Strategies in Health Care Coverage Program Outreach and Enrollment," Mathematica Policy Research Reports 7819, Mathematica Policy Research.
- Alberto Chong & Hugo Nopo & Vanessa Rios, 2009. "Do Welfare Programs Damage Interpersonal Trust? Experimental Evidence from Representative Samples for Four Latin American Cities," Research Department Publications 4609, Inter-American Development Bank, Research Department.
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