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The Effect of Medicaid Physician Fees on Take-up of Public Health Insurance among Children in Poverty

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  • Youjin Hahn

Abstract

I investigate how changes in fees paid to Medicaid physicians affect take-up among children in low-income families. The existing literature suggests that the low level of Medicaid fee payments to physicians reduces their willingness to see Medicaid patients, thus creating an access-to-care problem for these patients. For the identical service, current Medicaid reimbursement rates are only about 65 percent of those covered by Medicare. Increasing the relative payments of Medicaid would increase its perceived value, as it would provide better access to health care for Medicaid beneficiaries. Using variation in the timing of the changes in Medicaid payment across states, I find that increasing Medicaid generosity is associated with both an increase in take-up and a reduction in uninsured rate. These results provide a partial answer to the puzzling question of why many low-income children who are eligible for Medicaid remain uninsured.

Suggested Citation

  • Youjin Hahn, 2012. "The Effect of Medicaid Physician Fees on Take-up of Public Health Insurance among Children in Poverty," Monash Economics Working Papers 29-12, Monash University, Department of Economics.
  • Handle: RePEc:mos:moswps:2012-29
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    References listed on IDEAS

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    1. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 431-466.
    2. Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
    3. Currie, Janet & Gruber, Jonathan & Fischer, Michael, 1995. "Physician Payments and Infant Mortality: Evidence from Medicaid Fee Policy," American Economic Review, American Economic Association, vol. 85(2), pages 106-111, May.
    4. Jonathan Gruber & Kathleen Adams & Joseph P. Newhouse, 1997. "Physician Fee Policy and Medicaid Program Costs," Journal of Human Resources, University of Wisconsin Press, vol. 32(4), pages 611-634.
    5. Laurence C. Baker & Anne Beeson Royalty, 2000. "Medicaid Policy, Physician Behavior, and Health Care for the Low-Income Population," Journal of Human Resources, University of Wisconsin Press, vol. 35(3), pages 480-502.
    6. Currie, Janet & Fahr, John, 2005. "Medicaid managed care: effects on children's Medicaid coverage and utilization," Journal of Public Economics, Elsevier, vol. 89(1), pages 85-108, January.
    7. Lo Sasso, Anthony T. & Buchmueller, Thomas C., 2004. "The effect of the state children's health insurance program on health insurance coverage," Journal of Health Economics, Elsevier, vol. 23(5), pages 1059-1082, September.
    8. Anna Aizer, 2007. "Public Health Insurance, Program Take-Up, and Child Health," The Review of Economics and Statistics, MIT Press, vol. 89(3), pages 400-415, August.
    9. Long, Stephen H. & Settle, Russell F. & Stuart, Bruce C., 1986. "Reimbursement and access to physicians' services under Medicaid," Journal of Health Economics, Elsevier, vol. 5(3), pages 235-251, September.
    10. Nyman, John A., 1999. "The value of health insurance: the access motive," Journal of Health Economics, Elsevier, vol. 18(2), pages 141-152, April.
    11. Gertler, Paul & Locay, Luis & Sanderson, Warren, 1987. "Are user fees regressive? : The welfare implications of health care financing proposals in Peru," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 67-88.
    12. Levine Phillip B & Schanzenbach Diane, 2009. "The Impact of Children's Public Health Insurance Expansions on Educational Outcomes," Forum for Health Economics & Policy, De Gruyter, vol. 12(1), pages 1-28, May.
    13. Gruber, Jonathan & Simon, Kosali, 2008. "Crowd-out 10 years later: Have recent public insurance expansions crowded out private health insurance?," Journal of Health Economics, Elsevier, vol. 27(2), pages 201-217, March.
    14. Dahlia K. Remler & Jason E. Rachlin & Sherry A. Glied, 2001. "What can the take-up of other programs teach us about how to improve take-up of health insurance programs?," NBER Working Papers 8185, National Bureau of Economic Research, Inc.
    15. Sandra Decker, 2007. "Medicaid physician fees and the quality of medical care of Medicaid patients in the USA," Review of Economics of the Household, Springer, vol. 5(1), pages 95-112, March.
    16. McGuire, Thomas G. & Pauly, Mark V., 1991. "Physician response to fee changes with multiple payers," Journal of Health Economics, Elsevier, vol. 10(4), pages 385-410.
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    Cited by:

    1. Sonchak, Lyudmyla, 2015. "Medicaid reimbursement, prenatal care and infant health," Journal of Health Economics, Elsevier, vol. 44(C), pages 10-24.
    2. Pinka Chatterji & Sandra L. Decker & Jason Huh, 2022. "Medicaid physician fees and access to care among children with special health care needs," Review of Economics of the Household, Springer, vol. 20(3), pages 887-919, September.
    3. Yu, Serena & van Gool, Kees & Hall, Jane & Fiebig, Denzil G., 2019. "Physician pricing behavior: Evidence from an Australian experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 161(C), pages 20-34.
    4. Julie Janssens & Natascha Van Mechelen, 2017. "Who is to Blame? An Overview of the Factors Contributing to the Non-Take-Up of Social Rights," Working Papers 1708, Herman Deleeck Centre for Social Policy, University of Antwerp.
    5. Colleen M. Carey & Sarah Miller & Laura R. Wherry, 2020. "The Impact of Insurance Expansions on the Already Insured: The Affordable Care Act and Medicare," American Economic Journal: Applied Economics, American Economic Association, vol. 12(4), pages 288-318, October.
    6. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters, in: Economics of Means-Tested Transfer Programs in the United States, Volume 1, pages 21-136, National Bureau of Economic Research, Inc.
    7. Xiaoxue Li, 2020. "Quality information disclosure and health insurance demand: evidence from VA hospital report cards," International Journal of Health Economics and Management, Springer, vol. 20(2), pages 177-199, June.

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    More about this item

    Keywords

    Medicaid; Take-up; Medicaid payment; Medicaid reimbursement; Access to care;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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