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The Impact of the ACA Medicaid Expansion on Disability Program Applications

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  • Lucie Schmidt
  • Lara D. Shore-Sheppard
  • Tara Watson

Abstract

The Affordable Care Act (ACA) expanded the availability of public health insurance, decreasing the relative benefit of participating in disability programs but also lowering the cost of exiting the labor market to apply for disability benefits. In this paper, we explore the impact of expanded access to Medicaid through the ACA on applications to the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) programs. Using the fact that the Supreme Court decision of June 2012 made the Medicaid expansion optional for the states, we compare changes in county-level SSI and SSDI caseloads in contiguous county pairs across a state border. We find no significant effects of the Medicaid expansion on applications or awards to either SSI or SSDI, and can reject economically meaningful impacts of Medicaid expansions on applications to disability programs.

Suggested Citation

  • Lucie Schmidt & Lara D. Shore-Sheppard & Tara Watson, 2020. "The Impact of the ACA Medicaid Expansion on Disability Program Applications," American Journal of Health Economics, University of Chicago Press, vol. 6(4), pages 444-476.
    • Handle: RePEc:ucp:amjhec:doi:10.1086/710525
    DOI: 10.1086/710525
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    Cited by:

    1. Andre, Jennifer & Braga, Breno & Martinchek, Kassandra & McKernan, Signe-Mary, 2024. "The Effects of Utility Shutoff and Eviction Moratoria during the COVID-19 Pandemic on the Use of Alternative Financial Services Loans," IZA Discussion Papers 17248, Institute of Labor Economics (IZA).
    2. Andre, Jennifer & Braga, Breno & Martinchek, Kassandra & McKernan, Signe-Mary, 2024. "The effects of state utility shutoff moratoria on credit delinquencies during the COVID-19 pandemic," Journal of Economics and Business, Elsevier, vol. 129(C).
    3. Hamish Low & Luigi Pistaferri, 2020. "Disability Insurance: Theoretical Trade‐Offs and Empirical Evidence," Fiscal Studies, John Wiley & Sons, vol. 41(1), pages 129-164, March.
    4. Heim, Bradley & Lurie, Ithai & Mullen, Kathleen J. & Simon, Kosali, 2021. "How Much Do Outside Options Matter? The Effect of Subsidized Health Insurance on Social Security Disability Insurance Benefit Receipt," Journal of Health Economics, Elsevier, vol. 76(C).
    5. Vivekananda Das, 2025. "Public Health Insurance Expansion and Financial Well-Being Indicators Directly Evaluated by the Eligible: Evidence from the United States," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 176(2), pages 771-797, January.
    6. Messel, Matt & Swensen, Isaac & Urban, Carly, 2023. "The effects of expanding access to mental health services on SS(D)I applications and awards," Labour Economics, Elsevier, vol. 81(C).
    7. Guldi, Melanie & Hamersma, Sarah, 2023. "The effects of pregnancy-related Medicaid expansions on maternal, infant, and child health," Journal of Health Economics, Elsevier, vol. 87(C).
    8. Lindsey Rose Bullinger, 2021. "Child Support and the Affordable Care Act's Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(1), pages 42-77, January.
    9. Xiuming Dong & Johanna Catherine Maclean & David Powell, 2024. "Social Insurance Spillovers: Evidence From Paid Sick Leave Mandates and Workers' Compensation," NBER Working Papers 32751, National Bureau of Economic Research, Inc.
    10. Becky Staiger & Madeline Helfer & Jessica Van Parys, 2024. "The effect of Medicaid expansion on the take‐up of disability benefits by race and ethnicity," Health Economics, John Wiley & Sons, Ltd., vol. 33(3), pages 526-540, March.
    11. Maestas, Nicole & Mullen, Kathleen J. & Strand, Alexander, 2021. "The effect of economic conditions on the disability insurance program: Evidence from the great recession," Journal of Public Economics, Elsevier, vol. 199(C).
    12. Lucie Schmidt & Lara Shore-Sheppard & Tara Watson, 2019. "The Impact of Expanding Public Health Insurance on Safety Net Program Participation: Evidence from the ACA Medicaid Expansion," NBER Working Papers 26504, National Bureau of Economic Research, Inc.
    13. Levere, Michael & Hemmeter, Jeffrey & Wittenburg, David, 2024. "The importance of schools in driving children’s applications for disability benefits," Journal of Public Economics, Elsevier, vol. 239(C).
    14. Sumedha Gupta & Johanna Catherine Maclean & Christopher J. Ruhm & Kosali I. Simon, 2025. "The Impact of State Paid Sick Leave Mandates on Medicaid-financed Prescription Medications," NBER Working Papers 34485, National Bureau of Economic Research, Inc.

    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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