Saving Teens: Using a Policy Discontinuity to Estimate the Effects of Medicaid Eligibility
AbstractThis paper uses a policy discontinuity to identify the immediate and long-term effects of public health insurance coverage during childhood. Our identification strategy exploits a unique feature of several early Medicaid expansions that extended eligibility only to children born after September 30, 1983. This feature resulted in a large discontinuity in the lifetime years of Medicaid eligibility of children at this birthdate cutoff. Those with family incomes at or just below the poverty line had close to five more years of eligibility if they were born just after the cutoff than if they were born just before. We use this discontinuity in eligibility to measure the impact of public health insurance on mortality by following cohorts of children born on either side of this cutoff from childhood through early adulthood. We examine changes in rates of mortality by the underlying causes of death, distinguishing between deaths due to internal and external causes. We also examine outcomes separately for black and white children. Our analysis shows that black children were more likely to be affected by the Medicaid expansions and gained twice the amount of eligibility as white children. We find a substantial effect of public eligibility during childhood on the later life mortality of black children at ages 15-18. The estimates indicate a 13-20 percent decrease in the internal mortality rate of black teens born after September 30, 1983. We find no evidence of an improvement in the mortality of white children under the expansions.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoPaper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 18309.
Date of creation: Aug 2012
Date of revision:
Note: CH HC HE LS PE
Contact details of provider:
Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.
Web page: http://www.nber.org
More information through EDIRC
Find related papers by JEL classification:
- I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
- I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
This paper has been announced in the following NEP Reports:
- NEP-ALL-2012-08-23 (All new papers)
- NEP-HEA-2012-08-23 (Health Economics)
- NEP-IAS-2012-08-23 (Insurance Economics)
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Anne Case & Darren Lubotsky & Christina Paxson, 2001.
"Economic Status and Health in Childhood: The Origins of the Gradient,"
NBER Working Papers
8344, National Bureau of Economic Research, Inc.
- Anne Case & Darren Lubotsky & Christina Paxson, 2002. "Economic Status and Health in Childhood: The Origins of the Gradient," American Economic Review, American Economic Association, vol. 92(5), pages 1308-1334, December.
- Anne Case & Darren Lubotsky & Christina Paxson, 2002. "Economic status and health in childhood: the origins of the gradient," Working Papers 262, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
- David Card & Carlos Dobkin & Nicole Maestas, 2009.
"Does Medicare Save Lives?,"
The Quarterly Journal of Economics,
MIT Press, vol. 124(2), pages 597-636, May.
- Kasey S. Buckles & Daniel M. Hungerman, 2013.
"Season of Birth and Later Outcomes: Old Questions, New Answers,"
The Review of Economics and Statistics,
MIT Press, vol. 95(3), pages 711-724, July.
- Kasey Buckles & Daniel M. Hungerman, 2008. "Season of Birth and Later Outcomes: Old Questions, New Answers," NBER Working Papers 14573, National Bureau of Economic Research, Inc.
- Anne Case & Angela Fertig & Christina Paxson, 2004.
"The Lasting Impact of Childhood Health and Circumstance,"
246, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
- Case, Anne & Fertig, Angela & Paxson, Christina, 2005. "The lasting impact of childhood health and circumstance," Journal of Health Economics, Elsevier, vol. 24(2), pages 365-389, March.
- Lee, David S. & Card, David, 2008.
"Regression discontinuity inference with specification error,"
Journal of Econometrics,
Elsevier, vol. 142(2), pages 655-674, February.
- David S. Lee & David Card, 2006. "Regression Discontinuity Inference with Specification Error," NBER Technical Working Papers 0322, National Bureau of Economic Research, Inc.
- 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.
- Lo Sasso, Anthony T. & Buchmueller, Thomas C., 2004.
"The effect of the state children's health insurance program on health insurance coverage,"
Journal of Health Economics,
Elsevier, vol. 23(5), pages 1059-1082, September.
- Anthony T. LoSasso & Thomas C. Buchmueller, 2002. "The Effect of the State Children's Health Insurance Program on Health Insurance Coverage," NBER Working Papers 9405, National Bureau of Economic Research, Inc.
- Dolores De La Mata, 2012. "The Effect Of Medicaid Eligibility On Coverage, Utilization, And Children'S Health," Health Economics, John Wiley & Sons, Ltd., vol. 21(9), pages 1061-1079, 09.
- Currie, Janet & Decker, Sandra & Lin, Wanchuan, 2008.
"Has public health insurance for older children reduced disparities in access to care and health outcomes?,"
Journal of Health Economics,
Elsevier, vol. 27(6), pages 1567-1581, December.
- Janet Currie & Sandra Decker & Wanchuan Lin, 2008. "Has Public Health Insurance for Older Children Reduced Disparities in Access to Care and Health Outcomes?," NBER Working Papers 14173, National Bureau of Economic Research, Inc.
- Kaestner, R. & Joyce, T. & Racine, A., 2001. "Medicaid eligibility and the incidence of ambulatory care sensitive hospitalizations for children," Social Science & Medicine, Elsevier, vol. 52(2), pages 305-313, January.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ().
If references are entirely missing, you can add them using this form.