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Parental Medicaid Expansions and Health Insurance Coverage


  • Anna Aizer
  • Jeffrey Grogger


During the 1990s many states extended Medicaid eligibility to low-income parents who were not receiving welfare. We evaluate the effects of those expansions on health insurance coverage. To account for unobservable differences between expansion states and non-expansion states that may be correlated with both policy decisions and insurance coverage, we employ a within-state difference-in-difference technique that makes use of data only from expansion states. We find that the parental eligibility expansions increased Medicaid coverage of mothers with only small effects on private coverage. The expansions also increased the coverage of children, presumably by raising the benefit to the family of applying for coverage. We find substantial racial and ethnic differences in the effects of the expansions. As a result, the expansions help reduce racial and ethnic gaps in insurance coverage, particularly for adults.

Suggested Citation

  • Anna Aizer & Jeffrey Grogger, 2003. "Parental Medicaid Expansions and Health Insurance Coverage," NBER Working Papers 9907, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:9907
    Note: HE CH

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    References listed on IDEAS

    1. 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.
    2. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, Oxford University Press, vol. 111(2), pages 391-430.
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    Cited by:

    1. Marianne P. Bitler & Jonah Gelbach & Hilary Hoynes, 2003. "Welfare Reform and Health," Working Papers WR-102-1-NICHD/NIA, RAND Corporation.
    2. Hamersma, Sarah & Kim, Matthew, 2013. "Participation and crowd out: Assessing the effects of parental Medicaid expansions," Journal of Health Economics, Elsevier, vol. 32(1), pages 160-171.
    3. James Marton & Aaron Yelowitz, 2015. "Health insurance generosity and conditional coverage: Evidence from medicaid managed care in Kentucky," Southern Economic Journal, Southern Economic Association, vol. 82(2), pages 535-555, October.
    4. 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.
    5. Marianne P. Bitler & Jonah B. Gelbach & Hilary W. Hoynes, 2005. "Welfare Reform and Health," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
    6. Marianne Bitler & Hilary W. Hoynes, 2006. "Welfare Reform and Indirect Impacts on Health," NBER Working Papers 12642, National Bureau of Economic Research, Inc.
    7. David Zimmer, 2011. "The Effects of the State Children’s Health Insurance Program on Insurance Status and Health Care Utilization of Children," Journal of Family and Economic Issues, Springer, vol. 32(2), pages 373-383, June.
    8. Hamersma, Sarah & Kim, Matthew, 2009. "The effect of parental Medicaid expansions on job mobility," Journal of Health Economics, Elsevier, vol. 28(4), pages 761-770, July.
    9. Kasey Buckles & Joseph Price, 2013. "Selection and the Marriage Premium for Infant Health," Demography, Springer;Population Association of America (PAA), vol. 50(4), pages 1315-1339, August.
    10. Marianne P. Bitler & Jonah B. Gelbach & Hilary W. Hoynes, 2005. "Welfare Reform and Health," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
    11. Wolfe, Barbara & Kaplan, Thomas & Haveman, Robert & Cho, Yoonyoung, 2006. "SCHIP expansion and parental coverage: An evaluation of Wisconsin's BadgerCare," Journal of Health Economics, Elsevier, vol. 25(6), pages 1170-1192, November.
    12. Laura S. Hussey, 2010. "Welfare Generosity, Abortion Access, and Abortion Rates: A Comparison of State Policy Tools," Social Science Quarterly, Southwestern Social Science Association, vol. 91(1), pages 266-283.
    13. Buchmueller Thomas C & Lo Sasso Anthony T & Wong Kathleen N, 2008. "How Did SCHIP Affect the Insurance Coverage of Immigrant Children?," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 8(2), pages 1-25, January.
    14. Jonathan Gruber & Kosali Simon, 2007. "Crowd-Out Ten Years Later: Have Recent Public Insurance Expansions Crowded Out Private Health Insurance?," NBER Working Papers 12858, National Bureau of Economic Research, Inc.
    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. Currie, Janet & Decker, Sandra & Lin, Wanchuan, 2008. "Has public health insurance for older children reduced disparities in access to care and health outcomes?," Journal of Health Economics, Elsevier, vol. 27(6), pages 1567-1581, December.
    17. Cristian Pardo & Whitney Schott, 2012. "Public versus private: evidence on health insurance selection," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 39-61, March.
    18. Datta, Anusua & Vandegrift, Donald, 2011. "Effects of welfare reform and the state children’s health insurance program on medicaid and total health expenditures," MPRA Paper 36486, University Library of Munich, Germany.
    19. repec:pri:crcwel:wp06-10-ff is not listed on IDEAS
    20. Hope Corman & Anne Carroll & Kelly Noonan & Nancy E. Reichman, 2006. "The Effects of Health on Health Insurance Status in Fragile Families," NBER Working Papers 12197, National Bureau of Economic Research, Inc.

    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I3 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty

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