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The Impact of Expanding Public Health Insurance on Safety Net Program Participation: Evidence From the ACA Medicaid Expansion

Author

Listed:
  • Lucie Schmidt
  • Lara Shore-Sheppard
  • Tara Watson

Abstract

We examine spillover effects from the ACA Medicaid expansion to public programs providing cash and food assistance. We consider program participation in contiguous county pairs crossing state borders, where one state took up the Medicaid expansion and the other did not, allowing us to better control for local economic trends that could affect program participation. We find that the Medicaid expansion increased participation in food assistance and one of the cash programs, with impacts mainly due to participation conditional on eligibility, rather than from labor supply responses. Our results demonstrate the potential for spillovers across safety net programs.

Suggested Citation

  • Lucie Schmidt & Lara Shore-Sheppard & Tara Watson, 2026. "The Impact of Expanding Public Health Insurance on Safety Net Program Participation: Evidence From the ACA Medicaid Expansion," Working Papers 26-32, Center for Economic Studies, U.S. Census Bureau.
    • Handle: RePEc:cen:wpaper:26-32
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    File URL: https://www2.census.gov/library/working-papers/2026/adrm/ces/CES-WP-26-32.pdf
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    Cited by:

    1. is not listed on IDEAS
    2. Philip Armour & Melanie A. Zaber, 2020. "Does Student Loan Forgiveness Drive Disability Application?," NBER Working Papers 26787, National Bureau of Economic Research, Inc.
    3. 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.
    4. Anne T. Byrne & Bhagyashree Katare & John Lowrey, 2025. "Heterogeneous effects of Medicaid expansion on food security measures," American Journal of Agricultural Economics, John Wiley & Sons, vol. 107(3), pages 775-794, May.
    5. 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.
    6. Ruchi Avtar & Rajashri Chakrabarti & Lindsay Meyerson & William Nober & Maxim L. Pinkovskiy, 2020. "The Affordable Care Act and the COVID-19 Pandemic: A Regression Discontinuity Analysis," Staff Reports 948, Federal Reserve Bank of New York.
    7. Burney, Shaheer & Boehm, Rebecca & Lopez, Rigoberto, 2021. "The impact of the ACA Medicaid expansion on SNAP participation," Food Policy, Elsevier, vol. 101(C).
    8. Colleen Heflin & Jun Li & Dongmei Zuo, 2023. "Changing patterns of SNAP take‐up and participation and the role of out‐of‐pocket medical expenses among older adults," Applied Economic Perspectives and Policy, John Wiley & Sons, vol. 45(1), pages 336-349, March.

    More about this item

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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