IDEAS home Printed from https://ideas.repec.org/p/fip/fedhwp/97421.html

Medicaid-ing Uninsurance? The Impact of the Affordable Care Act’s Medicaid Expansion on Uninsurance Spells

Author

Listed:

Abstract

We study the effect of the Affordable Care Act’s Medicaid expansion on coverage dynamics following the sudden loss of coverage from an employer plan. This analysis leverages novel administrative data capturing monthly health insurance coverage for the U.S. population. Using these data, we develop several stylized facts describing the post-separation coverage dynamics. In addition, we use a difference-in-differences model to estimate the causal effect of Medicaid expansion on the duration of uninsurance following a separation from an employer plan. We find that Medicaid expansion increases the likelihood of finding coverage by 16% and reduces the duration of uninsurance by 12%.

Suggested Citation

  • Bradley T. Heim & Elena Patel & Shanthi Ramnath, 2023. "Medicaid-ing Uninsurance? The Impact of the Affordable Care Act’s Medicaid Expansion on Uninsurance Spells," Working Paper Series WP 2023-41, Federal Reserve Bank of Chicago.
    • Handle: RePEc:fip:fedhwp:97421
    DOI: 10.21033/wp-2023-41
    as

    Download full text from publisher

    File URL: https://doi.org/10.21033/wp-2023-41
    Download Restriction: no
    File URL: https://libkey.io/10.21033/wp-2023-41?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
    ---><---

    References listed on IDEAS

    as
    1. Gross, Tal & Notowidigdo, Matthew J., 2011. "Health insurance and the consumer bankruptcy decision: Evidence from expansions of Medicaid," Journal of Public Economics, Elsevier, vol. 95(7-8), pages 767-778, August.
    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. Ithai Z. Lurie & James Pearce, 2021. "Health Insurance Coverage in Tax and Survey Data," American Journal of Health Economics, University of Chicago Press, vol. 7(2), pages 164-184.
    4. Hu, Luojia & Kaestner, Robert & Mazumder, Bhashkar & Miller, Sarah & Wong, Ashley, 2018. "The effect of the affordable care act Medicaid expansions on financial wellbeing," Journal of Public Economics, Elsevier, vol. 163(C), pages 99-112.
    5. Cutler, David M. & Gelber, Alexander M., 2009. "Changes in the Incidence and Duration of Periods Without Insurance," Scholarly Articles 5344531, Harvard University Department of Economics.
    6. Schaller, Jessamyn & Stevens, Ann Huff, 2015. "Short-run effects of job loss on health conditions, health insurance, and health care utilization," Journal of Health Economics, Elsevier, vol. 43(C), pages 190-203.
    7. Masanori Kuroki, 2021. "The effect of health insurance coverage on personal bankruptcy: evidence from the Medicaid expansion," Review of Economics of the Household, Springer, vol. 19(2), pages 429-451, June.
    Full references (including those not matched with items on IDEAS)

    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. 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.
    2. 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.
    3. Cortnie Shupe, 2023. "Public Health Insurance and Medical Spending: The Incidence of the ACA Medicaid Expansion," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(1), pages 137-165, January.
    4. Brevoort, Kenneth & Grodzicki, Daniel & Hackmann, Martin B., 2020. "The credit consequences of unpaid medical bills," Journal of Public Economics, Elsevier, vol. 187(C).
    5. Paul Goldsmith-Pinkham & Maxim Pinkovskiy & Jacob Wallace, 2020. "Medicare and the Geography of Financial Health," Working Papers 2020-004, Human Capital and Economic Opportunity Working Group.
    6. Masanori Kuroki, 2021. "The effect of health insurance coverage on personal bankruptcy: evidence from the Medicaid expansion," Review of Economics of the Household, Springer, vol. 19(2), pages 429-451, June.
    7. Paul Goldsmith-Pinkham & Maxim L. Pinkovskiy & Jacob Wallace, 2020. "The Great Equalizer: Medicare and the Geography of Consumer Financial Strain," Staff Reports 911, Federal Reserve Bank of New York.
    8. 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.
    9. 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.
    10. Michael R. Richards & Sebastian Tello‐Trillo, 2021. "Private coverage mandates, business cycles, and provider treatment intensity," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1200-1221, May.
    11. Yaa Akosa Antwi & Marion Aouad & Nathan Blascak, 2025. "Hospital Billing Regulations and Financial Well-Being: Evidence from California’s Fair Pricing Law," Working Papers 25-39, Federal Reserve Bank of Philadelphia.
    12. Antonios M. Koumpias & Charles Courtemanche & Jordan W. Jones & Daniela Zapata, 2024. "Revisiting the connection between state Medicaid expansions and adult mortality," Southern Economic Journal, John Wiley & Sons, vol. 91(1), pages 187-212, July.
    13. Owen (O.A.) O'Donnell, 2019. "Financial Protection Against Medical Expense," Tinbergen Institute Discussion Papers 19-010/V, Tinbergen Institute.
    14. David J. G. Slusky & Donna K. Ginther, 2021. "Did Medicaid expansion reduce medical divorce?," Review of Economics of the Household, Springer, vol. 19(4), pages 1139-1174, December.
    15. Tom Potoms & Sarah Rosenberg, 2024. "Public insurance and marital outcomes: Evidence from the Affordable Care Act's Medicaid expansions," IFS Working Papers W24/53, Institute for Fiscal Studies.
    16. Helen Levy & Thomas Buchmueller & Sayeh Nikpay, 2019. "The Impact of Medicaid Expansion on Household Consumption," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 45(1), pages 34-57, January.
    17. Jang, Youngsoo, 2019. "Credit, Default, and Optimal Health Insurance," MPRA Paper 95397, University Library of Munich, Germany.
    18. Ha Trong Nguyen & Huong Thu Le & Luke Connelly & Francis Mitrou, 2023. "Accuracy of self‐reported private health insurance coverage," Health Economics, John Wiley & Sons, Ltd., vol. 32(12), pages 2709-2729, December.
    19. Paul Heaton & Caleb Flint, 2021. "Medicaid coverage expansions and liability insurance," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 88(1), pages 29-51, March.
    20. Patryk Babiarz & Tansel Yilmazer, 2017. "The impact of adverse health events on consumption: Understanding the mediating effect of income transfers, wealth, and health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1743-1758, December.

    More about this item

    Keywords

    ;
    ;
    ;

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • J65 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Unemployment Insurance; Severance Pay; Plant Closings

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    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:fip:fedhwp:97421. 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: Lauren Wiese (email available below). General contact details of provider: https://edirc.repec.org/data/frbchus.html .

    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.