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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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Abstract

Despite intensive scrutiny, the effects of Medicaid expansions on the health insurance status of low-income children remain controversial. We re-examine 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 crowd-out of private insurance coverage.

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File URL: http://web.williams.edu/Economics/wp/shoresheppardC_S-Sfin.pdf
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Paper provided by Department of Economics, Williams College in its series Department of Economics Working Papers with number 2003-09.

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Length: 51 pages
Date of creation: Dec 2003
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Publication status: published in Review of Economics and Statistics, vol. 86, no. 3, August 2004, pp. 752-766.
Handle: RePEc:wil:wileco:2003-09

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  1. 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.
  2. Joshua Angrist & Alan Krueger, 1998. "Empirical Strategies in Labor Economics," Working papers 98-7, Massachusetts Institute of Technology (MIT), Department of Economics.
  3. Pischke, Jörn-Steffen, 1991. "Individual income, incomplete information, and aggregate consumption," ZEW Discussion Papers 91-07, ZEW - Zentrum für Europäische Wirtschaftsforschung / Center for European Economic Research.
  4. 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.
  5. 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.
  6. 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.
  7. David M. Cutler & Jonathan Gruber, 1995. "Does Public Insurance Crowd Out Private Insurance?," NBER Working Papers 5082, National Bureau of Economic Research, Inc.
  8. 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.
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