Effects of welfare reform and the state children’s health insurance program on medicaid and total health expenditures
AbstractMedicaid expenditures account for a sizeable proportion of U.S. GDP - $360.3 billion in 2009 or 2.55 percent of GDP. Despite this, the Affordable Care Act of 2010 (i.e. the new Obama healthcare initiative) further expands eligibility criteria for the Medicaid program. However, there is little literature on the effect on healthcare spending from earlier expansions of Medicaid such as the introduction of the SCHIP program. Moreover, the effect of welfare reform (i.e. Personal Responsibility and Work Opportunity Reconciliation Act of 1996) on Medicaid spending has received little attention. Using panel data from all 50 U.S. states for the period 1990-2004, we find that adding one person to the SCHIP rolls in a state that has established an SCHIP program in Medicaid raises real Medicaid spending about $4,100. However, we find evidence that additional SCHIP enrollments also affect non-Medicaid health spending. Thus, the total costs of insuring these patients are significantly higher (about $7,700). For states that have established Medicaid-combined programs, adding one person to the SCHIP rolls raises real healthcare spending about $1,800 after two years. Finally, we find that welfare reform reduced annual Medicaid expenditures by about $1.2 billion and total healthcare spending by about $2.5 billion.
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 University Library of Munich, Germany in its series MPRA Paper with number 36486.
Date of creation: 20 Dec 2011
Date of revision:
Healthcare costs; Medicaid; SCHIP; Welfare Reform;
Find related papers by JEL classification:
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
- I38 - Health, Education, and Welfare - - Welfare and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
- I00 - Health, Education, and Welfare - - General - - - General
This paper has been announced in the following NEP Reports:
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.:
- Jonathan Gruber, 2008. "Covering the Uninsured in the United States," Journal of Economic Literature, American Economic Association, vol. 46(3), pages 571-606, September.
- Anna Aizer & Jeffrey Grogger, 2003. "Parental Medicaid Expansions and Health Insurance Coverage," NBER Working Papers 9907, National Bureau of Economic Research, Inc.
- 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.
- Janet Currie & Jonathan Gruber, 1995. "Health Insurance Eligibility, Utilization of Medical care, and Child Health," NBER Working Papers 5052, National Bureau of Economic Research, Inc.
- David M. Cutler & Jonathan Gruber, 1995.
"Does Public Insurance Crowd Out Private Insurance?,"
NBER Working Papers
5082, National Bureau of Economic Research, Inc.
- 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.
- Anna A. Amirkhanyan & Hyun Joon Kim & Kristina T. Lambright, 2008. "Does the public sector outperform the nonprofit and for-profit sectors? Evidence from a national panel study on nursing home quality and access," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 27(2), pages 326-353.
- 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.
- 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.
- Busch, Susan H. & Duchovny, Noelia, 2005. "Family coverage expansions: Impact on insurance coverage and health care utilization of parents," Journal of Health Economics, Elsevier, vol. 24(5), pages 876-890, September.
- Baicker, Katherine, 2001. "Government decision-making and the incidence of federal mandates," Journal of Public Economics, Elsevier, vol. 82(2), pages 147-194, November.
- Louis F Rossiter & Randy F Neice, 2006. "Medicaid, State Finances, and the Bottom Line for Businesses," Business Economics, Palgrave Macmillan, vol. 41(3), pages 49-54, July.
- Louise Sheiner & David M. Cutler, 1999.
"The Geography of Medicare,"
American Economic Review,
American Economic Association, vol. 89(2), pages 228-233, May.
- David Wildasin & James Marton, 2007. "Medicaid Expenditures and State Budgets: Past, Present, and Future," Working Papers 2007-04, University of Kentucky, Institute for Federalism and Intergovernmental Relations.
- Ham, John C. & Shore-Sheppard, Lara, 2005.
"The effect of Medicaid expansions for low-income children on Medicaid participation and private insurance coverage: evidence from the SIPP,"
Journal of Public Economics,
Elsevier, vol. 89(1), pages 57-83, January.
- Lara D. Shore-Sheppard & John C. Ham, 2003. "The Effect of Medicaid Expansions for Low-Income Children on Medicaid Participation and Private Insurance Coverage : Evidence from the SIPP," Department of Economics Working Papers 2003-10, Department of Economics, Williams College.
- 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.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Ekkehart Schlicht).
If references are entirely missing, you can add them using this form.