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The Value of Medicaid: Interpreting Results from the Oregon Health Insurance Experiment

Author

Listed:
  • Amy Finkelstein
  • Nathaniel Hendren
  • Erzo F.P. Luttmer

Abstract

We develop a set of frameworks for valuing Medicaid and apply them to welfare analysis of the Oregon Health Insurance Experiment, a Medicaid expansion for low-income, uninsured adults that occurred via random assignment. Our baseline estimates of Medicaid's welfare benefit to recipients per dollar of government spending range from about $0.2 to $0.4, depending on the framework, with at least two-fifths – and as much as four-fifths – of the value of Medicaid coming from a transfer component, as opposed to its ability to move resources across states of the world. In addition, we estimate that Medicaid generates a substantial transfer, of about $0.6 per dollar of government spending, to the providers of implicit insurance for the low-income uninsured. The economic incidence of these transfers is critical for assessing the social value of providing Medicaid to low-income adults relative to alternative redistributive policies.

Suggested Citation

  • Amy Finkelstein & Nathaniel Hendren & Erzo F.P. Luttmer, 2015. "The Value of Medicaid: Interpreting Results from the Oregon Health Insurance Experiment," NBER Working Papers 21308, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:21308
    Note: AG HC PE
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    Cited by:

    1. Zhuan Pei, 2017. "Eligibility Recertification and Dynamic Opt-In Incentives in Income-Tested Social Programs: Evidence from Medicaid/CHIP," American Economic Journal: Economic Policy, American Economic Association, vol. 9(1), pages 241-276, February.
    2. Fadlon, Itzik & Nielsen, Torben Heien, 2019. "Household labor supply and the gains from social insurance," Journal of Public Economics, Elsevier, vol. 171(C), pages 18-28.
    3. Gizem Kosar & Robert A. Moffitt, 2017. "Trends in Cumulative Marginal Tax Rates Facing Low-Income Families, 1997-2007," Tax Policy and the Economy, University of Chicago Press, vol. 31(1), pages 43-70.
    4. Gabriella Conti & Rita Ginja, Renata Narita, 2017. "Non-Contributory Health Insurance and Household Labor Supply: Evidence from Mexico," Working Papers, Department of Economics 2017_17, University of São Paulo (FEA-USP).
    5. Jeffrey Clemens & Lisa B. Kahn & Jonathan Meer, 2018. "The Minimum Wage, Fringe Benefits, and Worker Welfare," NBER Working Papers 24635, National Bureau of Economic Research, Inc.
    6. Robert Kaestner & Darren Lubotsky, 2016. "Health Insurance and Income Inequality," Journal of Economic Perspectives, American Economic Association, vol. 30(2), pages 53-78, Spring.
    7. David Autor & Andreas Kostøl & Magne Mogstad & Bradley Setzler, 2019. "Disability Benefits, Consumption Insurance, and Household Labor Supply," American Economic Review, American Economic Association, vol. 109(7), pages 2613-2654, July.
    8. Sonia Jaffe & Mark Shepard, 2017. "Price-Linked Subsidies and Health Insurance Markups," Working Papers 2017-084, Human Capital and Economic Opportunity Working Group.
    9. repec:aea:aejapp:v:10:y:2018:i:1:p:1-39 is not listed on IDEAS
    10. Marika Cabral & Mark R. Cullen, 2016. "Estimating the Value of Public Insurance Using Complementary Private Insurance," NBER Working Papers 22583, National Bureau of Economic Research, Inc.
    11. repec:tpr:amjhec:v:3:y:2017:i:3:p:392-421 is not listed on IDEAS
    12. Sonia P. Jaffe & Mark Shepard, 2017. "Price-Linked Subsidies and Imperfect Competition in Health Insurance," NBER Working Papers 23104, National Bureau of Economic Research, Inc.
    13. Alan J. Auerbach & Laurence J. Kotlikoff & Darryl Koehler & Manni Yu, 2017. "Is Uncle Sam Inducing the Elderly to Retire?," Tax Policy and the Economy, University of Chicago Press, vol. 31(1), pages 1-42.
    14. Brian Knight & Nathan Schiff, 2019. "The Out-of-State Tuition Distortion," American Economic Journal: Economic Policy, American Economic Association, vol. 11(1), pages 317-350, February.
    15. 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.
    16. Craig Garthwaite & Tal Gross & Matthew J. Notowidigdo, 2018. "Hospitals as Insurers of Last Resort," American Economic Journal: Applied Economics, American Economic Association, vol. 10(1), pages 1-39, January.
    17. Titus J. Galama & Adriana Lleras-Muney & Hans van Kippersluis, 2018. "The Effect of Education on Health and Mortality: A Review of Experimental and Quasi-Experimental Evidence," NBER Working Papers 24225, National Bureau of Economic Research, Inc.
    18. Luojia Hu & Robert Kaestner & Bhashkar Mazumder & Sarah Miller & Ashley Wong, 2016. "The Effect of the Patient Protection and Affordable Care Act Medicaid Expansions on Financial Wellbeing," NBER Working Papers 22170, National Bureau of Economic Research, Inc.
    19. Andrew Goodman-Bacon, 2016. "The Long-Run Effects of Childhood Insurance Coverage: Medicaid Implementation, Adult Health, and Labor Market Outcomes," NBER Working Papers 22899, National Bureau of Economic Research, Inc.
    20. Kavan Kucko & Kevin Rinz & Benjamin Solow, 2017. "Labor Market Effects of the Affordable Care Act: Evidence from a Tax Notch," CARRA Working Papers 2017-07, Center for Economic Studies, U.S. Census Bureau.

    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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