IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Login to save this paper or follow this series

Effects of welfare reform and the state children’s health insurance program on medicaid and total health expenditures

  • Datta, Anusua
  • Vandegrift, Donald

Medicaid expenditures account for a sizeable proportion of U.S. GDP - $360.3 billion in 2009 or 2.55 percent of GDP. Despite this, the Affordable Care Act of 2010 (i.e. the new Obama healthcare initiative) further expands eligibility criteria for the Medicaid program. However, there is little literature on the effect on healthcare spending from earlier expansions of Medicaid such as the introduction of the SCHIP program. Moreover, the effect of welfare reform (i.e. Personal Responsibility and Work Opportunity Reconciliation Act of 1996) on Medicaid spending has received little attention. Using panel data from all 50 U.S. states for the period 1990-2004, we find that adding one person to the SCHIP rolls in a state that has established an SCHIP program in Medicaid raises real Medicaid spending about $4,100. However, we find evidence that additional SCHIP enrollments also affect non-Medicaid health spending. Thus, the total costs of insuring these patients are significantly higher (about $7,700). For states that have established Medicaid-combined programs, adding one person to the SCHIP rolls raises real healthcare spending about $1,800 after two years. Finally, we find that welfare reform reduced annual Medicaid expenditures by about $1.2 billion and total healthcare spending by about $2.5 billion.

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

File URL: http://mpra.ub.uni-muenchen.de/36486/1/MPRA_paper_36486.pdf
File Function: original version
Download Restriction: no

Paper provided by University Library of Munich, Germany in its series MPRA Paper with number 36486.

as
in new window

Length:
Date of creation: 20 Dec 2011
Date of revision:
Handle: RePEc:pra:mprapa:36486
Contact details of provider: Postal: Schackstr. 4, D-80539 Munich, Germany
Phone: +49-(0)89-2180-2219
Fax: +49-(0)89-2180-3900
Web page: http://mpra.ub.uni-muenchen.de

More information through EDIRC

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

as in new window
  1. Skinner, Jonathan & Fisher, Elliott, 1997. "Regional Disparities in Medicare Expenditures: An Opportunity for Reform," National Tax Journal, National Tax Association, vol. 50(3), pages 413-25, September.
  2. Busch, Susan H. & Duchovny, Noelia, 2005. "Family coverage expansions: Impact on insurance coverage and health care utilization of parents," Journal of Health Economics, Elsevier, vol. 24(5), pages 876-890, September.
  3. Ham, John C. & Shore-Sheppard, Lara, 2005. "The effect of Medicaid expansions for low-income children on Medicaid participation and private insurance coverage: evidence from the SIPP," Journal of Public Economics, Elsevier, vol. 89(1), pages 57-83, January.
  4. Louis F Rossiter & Randy F Neice, 2006. "Medicaid, State Finances, and the Bottom Line for Businesses," Business Economics, Palgrave Macmillan, vol. 41(3), pages 49-54, July.
  5. David Wildasin & James Marton, 2007. "Medicaid Expenditures and State Budgets: Past, Present, and Future," Working Papers 2007-04, University of Kentucky, Institute for Federalism and Intergovernmental Relations.
  6. 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.
  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. Jonathan Gruber, 2008. "Covering the Uninsured in the United States," Journal of Economic Literature, American Economic Association, vol. 46(3), pages 571-606, September.
  9. David M. Cutler & Louise Sheiner, 1999. "The geography of Medicare," Finance and Economics Discussion Series 1999-18, Board of Governors of the Federal Reserve System (U.S.).
  10. 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.
  11. Anna Aizer & Jeffrey Grogger, 2003. "Parental Medicaid Expansions and Health Insurance Coverage," NBER Working Papers 9907, National Bureau of Economic Research, Inc.
  12. Baicker, Katherine, 2001. "Government decision-making and the incidence of federal mandates," Journal of Public Economics, Elsevier, vol. 82(2), pages 147-194, November.
  13. Anna A. Amirkhanyan & Hyun Joon Kim & Kristina T. Lambright, 2008. "Does the public sector outperform the nonprofit and for-profit sectors? Evidence from a national panel study on nursing home quality and access," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 27(2), pages 326-353.
  14. David M. Cutler & Jonathan Gruber, 1995. "Does Public Insurance Crowd Out Private Insurance?," NBER Working Papers 5082, National Bureau of Economic Research, Inc.
Full references (including those not matched with items on IDEAS)

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

When requesting a correction, please mention this item's handle: RePEc:pra:mprapa:36486. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Ekkehart Schlicht)

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.