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The Effect of Disenrollment from Medicaid on Employment, Insurance Coverage, Health and Health Care Utilization

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  • Thomas DeLeire

Abstract

This study examines the effect of a Medicaid disenrollment on employment, sources of health insurance coverage, health, and health care utilization of childless adults using longitudinal data from the 2004 Panel of the Survey of Income and Program Participation. From July through September 2005, TennCare, the Tennessee Medicaid program, disenrolled approximately 170,000 adults following a change in eligibility rules. Following this eligibility change, the fraction of adults in Tennessee covered by Medicaid fell by over 5 percentage points while uninsured rates increased by almost 5 percentage points relative to adults in other Southern states. There is no evidence of an increase in employment rates in Tennessee following the disenrollment. Self-reported health and access to medical care worsened as hospitalization rates, doctor visits, and dentist visits all declined while the use of free or public clinics increased. The Tennessee experience suggests that undoing the expansion of Medicaid eligibility to adults that occurred under the Affordable Care Act likely would reduce health insurance coverage, reduce health care access, and worsen health but would not lead to increases in employment.

Suggested Citation

  • Thomas DeLeire, 2018. "The Effect of Disenrollment from Medicaid on Employment, Insurance Coverage, Health and Health Care Utilization," NBER Working Papers 24899, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:24899
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    Cited by:

    1. Maclean, Johanna Catherine & Tello-Trillo, Sebastian & Webber, Douglas, 2023. "Losing insurance and psychiatric hospitalizations," Journal of Economic Behavior & Organization, Elsevier, vol. 205(C), pages 508-527.
    2. Maclean, J. Catherine & Tello-Trillo, Sebastian & Webber, Douglas A., 2019. "Losing Insurance and Behavioral Health Hospitalizations: Evidence from a Large-Scale Medicaid Disenrollment," IZA Discussion Papers 12463, Institute of Labor Economics (IZA).
    3. Thomas C. Buchmueller & Helen Levy & Robert G. Valletta, 2021. "Medicaid Expansion and the Unemployed," Journal of Labor Economics, University of Chicago Press, vol. 39(S2), pages 575-617.
    4. Timothy J. Halliday & Tetine Sentell & Megan Inada & Randall Q. Akee & Jill Miyamura, 2019. "The Impact of Public Health Insurance on Medical Utilization in a Vulnerable Population: Evidence from COFA Migrants," Working Papers 201905, University of Hawaii at Manoa, Department of Economics.
    5. Seonghoon Kim & Kanghyock Koh, 2022. "Health insurance and subjective well‐being: Evidence from two healthcare reforms in the United States," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 233-249, January.

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply

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