IDEAS home Printed from https://ideas.repec.org/a/eee/epplan/v99y2023ics0149718923000812.html
   My bibliography  Save this article

The effect of medicaid expansion on access to healthcare, health behaviors and health outcomes between expansion and non-expansion states

Author

Listed:
  • Romero, Toni
  • Ponomariov, Branco

Abstract

In 1965, Medicaid was implemented with the goal of providing insurance to low-income individuals. In 2010, the Patient Protection Affordable Care Act (PPACA) standardized and expanded the eligibility criteria for the Medicaid program across the United States. In 2012, the constitutionality of this expansion was challenged and the Supreme Court rules that states were only required to expand their Medicaid program if they wanted to utilize the additional funds allotted by the federal government. This research paper examines the effects of the expansion by looking at health data in expansion and non-expansion states. Specifically, this study compares metrics designed to gauge healthcare access, health behaviors and health outcomes to determine if expansion has had positive overall effect on expansion states. We conclude that expansion states have demonstrated improved access to healthcare and improved health outcomes than the non-expansion states. Changes in health behaviors reflect mixed results – HIV screenings are higher in expansion states but participation in flu vaccinations show no statistical significance difference between the two groups. Given the results of this analysis, we conclude that Medicaid expansion is an effective policy for states to pursue in order to further the original objectives of Medicaid by improving the health of low-income recipients.

Suggested Citation

  • Romero, Toni & Ponomariov, Branco, 2023. "The effect of medicaid expansion on access to healthcare, health behaviors and health outcomes between expansion and non-expansion states," Evaluation and Program Planning, Elsevier, vol. 99(C).
    • Handle: RePEc:eee:epplan:v:99:y:2023:i:c:s0149718923000812
    DOI: 10.1016/j.evalprogplan.2023.102304
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0149718923000812
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.evalprogplan.2023.102304?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. DeVoe, J.E. & Fryer, G.E. & Phillips, R. & Green, L., 2003. "Receipt of Preventive Care among Adults: Insurance Status and Usual Source of Care," American Journal of Public Health, American Public Health Association, vol. 93(5), pages 786-791.
    2. Frean, Molly & Gruber, Jonathan & Sommers, Benjamin D., 2017. "Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act," Journal of Health Economics, Elsevier, vol. 53(C), pages 72-86.
    3. Xuesong Han & Binh T Nguyen & Jeffrey Drope & Ahmedin Jemal, 2015. "Health-Related Outcomes among the Poor: Medicaid Expansion vs. Non-Expansion States," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-11, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. de Melo Santos, Carlos Jefferson & Sant’Anna, Angelo Marcio Oliveira, 2024. "Evaluation of the public policy impacts on Monkeypox in Brazil," Evaluation and Program Planning, Elsevier, vol. 103(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Naomi Zewde, 2020. "The individual welfare effects of the Affordable Care Act for previously uninsured adults," International Journal of Health Economics and Management, Springer, vol. 20(2), pages 121-143, June.
    2. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    3. Erkmen Giray Aslim, 2019. "The Relationship Between Health Insurance and Early Retirement: Evidence from the Affordable Care Act," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 45(1), pages 112-140, January.
    4. Joan Costa-Font & Nilesh Raut & Courtney H. Van Houtven, 2024. "Medicaid Expansion and the Mental Health of Spousal Caregivers," Review of Economics of the Household, Springer, vol. 22(3), pages 1047-1084, September.
    5. Francesco Renna & Vasilios D. Kosteas & Kuchibhotla Dinkar, 2021. "Inequality in health insurance coverage before and after the Affordable Care Act," Health Economics, John Wiley & Sons, Ltd., vol. 30(2), pages 384-402, February.
    6. Isaac, Elliott & Jiang, Haibin, 2022. "Tax-Based Marriage Incentives in the Affordable Care Act," IZA Discussion Papers 15331, Institute of Labor Economics (IZA).
    7. Mark Duggan & Atul Gupta & Emilie Jackson, 2022. "The Impact of the Affordable Care Act: Evidence from California's Hospital Sector," American Economic Journal: Economic Policy, American Economic Association, vol. 14(1), pages 111-151, February.
    8. Saltzman, Evan, 2019. "Demand for health insurance: Evidence from the California and Washington ACA exchanges," Journal of Health Economics, Elsevier, vol. 63(C), pages 197-222.
    9. Etti G. Baranoff & Thomas W. Sager & Bo Shi & Dalit Baranoff, 2023. "On the financial superiority of Medicaid specialist insurers: a novel transactions cost/supply chain approach," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 32-67, January.
    10. Padmaja Ayyagari, 2019. "Health Insurance and Early Retirement Plans: Evidence from the Affordable Care Act," American Journal of Health Economics, University of Chicago Press, vol. 5(4), pages 533-560, Fall.
    11. Timothy J. Halliday & Randall Q. Akee, 2020. "The impact of Medicaid on medical utilization in a vulnerable population: Evidence from COFA migrants," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1231-1250, October.
    12. Samuel Dodini, 2023. "Insurance Subsidies, the Affordable Care Act, and Financial Stability," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(1), pages 97-136, January.
    13. Debdeep Chattopadhyay, 2023. "Did the Massachusetts Health Reform Program increase self-employment?," Empirical Economics, Springer, vol. 65(3), pages 1309-1344, September.
    14. Melissa McInerney & Jennifer M. Mellor & Lindsay M. Sabik, 2021. "Welcome Mats and On‐Ramps for Older Adults: The Impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(1), pages 12-41, January.
    15. Benjamin R. Handel & Jonathan T. Kolstad, 2021. "The Affordable Care Act After a Decade: Industrial Organization of the Insurance Exchanges," NBER Working Papers 29178, National Bureau of Economic Research, Inc.
    16. Stephan F. Gohmann, 2005. "Preventive Care And Insurance Coverage," Contemporary Economic Policy, Western Economic Association International, vol. 23(4), pages 513-528, October.
    17. Courtemanche, Charles & Friedson, Andrew I. & Rees, Daniel I., 2018. "Ambulance Utilization in New York City after the Implementation of the Affordable Care Act," IZA Discussion Papers 11444, Institute of Labor Economics (IZA).
    18. Kevin Wood, 2019. "Health insurance reform and retirement: Evidence from the Affordable Care Act," Health Economics, John Wiley & Sons, Ltd., vol. 28(12), pages 1462-1475, December.
    19. Judith Liu & Yuting Zhang, 2023. "Elderly responses to private health insurance incentives: Evidence from Australia," Health Economics, John Wiley & Sons, Ltd., vol. 32(12), pages 2730-2744, December.
    20. Sarah Miller & Luojia Hu & Robert Kaestner & Bhashkar Mazumder & Ashley Wong, 2021. "The ACA Medicaid Expansion in Michigan and Financial Health," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(2), pages 348-375, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:epplan:v:99:y:2023:i:c:s0149718923000812. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/evalprogplan .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.