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Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low Income Children

  • David Card
  • Lara D. Shore-Sheppard

This paper exploits the discrete nature of the eligibility criteria for two major federal expansions of Medicaid to measure the effects on Medicaid coverage, overall health insurance coverage, and the probability of visiting a doctor. The '100 percent' expansion, effective in 1991, extended Medicaid eligibility to children born after September 30, 1983 in families below the poverty line. We estimate that this law led to about a 10 percentage point rise in Medicaid coverage for children born just after the cutoff date, and a similar or slightly smaller rise in overall health insurance. It also increased the fraction of children in the newly eligible group with a doctor visit in the previous year. The '133 percent' expansion, effective in 1990, extended Medicaid to children under 6 in families with incomes below 133 percent of the poverty line. This law had relatively small effects on Medicaid coverage for children near the eligibility limits, and little or no effect on health insurance coverage.

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File URL: http://www.nber.org/papers/w9058.pdf
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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 9058.

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Date of creation: Jul 2002
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Publication status: published as David Card & Lara D. Shore-Sheppard, 2004. "Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low-Income Children," The Review of Economics and Statistics, MIT Press, vol. 86(3), pages 752-766, November.
Handle: RePEc:nbr:nberwo:9058
Note: CH HC PE
Contact details of provider: Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.
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  1. Lara Shore-Sheppard, 1996. "The Effects of Expanding Medicaid Eligibility on the Distribution of Children's Health Insurance Coverage," Working Papers 748, Princeton University, Department of Economics, Industrial Relations Section..
  2. Cutler, David M & Gruber, Jonathan, 1996. "Does Public Insurance Crowd Out Private Insurance?," The Quarterly Journal of Economics, MIT Press, vol. 111(2), pages 391-430, May.
  3. Pishke, J.S., 1992. "Individual Income, Incomplete Information and Aggregate Consumption," Papers 9238, Tilburg - Center for Economic Research.
  4. Joshua Angrist & Alan Krueger, 1998. "Empirical Strategies in Labor Economics," Working Papers 780, Princeton University, Department of Economics, Industrial Relations Section..
  5. John Ham & Lara Dawn Shore-Sheppard, 2000. "The Effect of Medicaid Expansions for Low-Income Children on Medicaid Participation and Insurance Coverage: Evidence from the SIPP," JCPR Working Papers 164, Northwestern University/University of Chicago Joint Center for Poverty Research.
  6. David Card & Lara Dawn Shore-Sheppard, 2001. "Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions," JCPR Working Papers 248, Northwestern University/University of Chicago Joint Center for Poverty Research.
  7. Lara D. Shore-Sheppard, 2000. "The Effect of expanding medicaid eligibility on the distribution of childrenÆs health insurance coverage," Industrial and Labor Relations Review, ILR Review, Cornell University, ILR School, vol. 54(1), pages 59-77, October.
  8. Janet Currie & Jonathan Gruber, 1995. "Health Insurance Eligibility, Utilization of Medical care, and Child Health," NBER Working Papers 5052, National Bureau of Economic Research, Inc.
  9. Lara D. Shore-Sheppard, 2000. "The Effect of Expanding Medicaid Eligibility on the Distribution of Children's Health Insurance Coverage," ILR Review, Cornell University, ILR School, vol. 54(1), pages 59-77, October.
  10. Blumberg, Linda J. & Dubay, Lisa & Norton, Stephen A., 2000. "Did the Medicaid expansions for children displace private insurance? An analysis using the SIPP," Journal of Health Economics, Elsevier, vol. 19(1), pages 33-60, January.
  11. Esel Y. Yazici & Robert Kaestner, 1998. "Medicaid Expansions and The Crowding Out of Private Health Insurance," NBER Working Papers 6527, National Bureau of Economic Research, Inc.
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