IDEAS home Printed from https://ideas.repec.org/p/pri/indrel/647.html
   My bibliography  Save this paper

State Responses to Federal Matching Grants: The Case of Medicaid

Author

Listed:
  • Pauline Leung

    (Cornell University)

Abstract

While Medicaid is currently financed by open-ended matching, in which the federal government pays an uncapped percentage of program expenditures, there has been interest in trans-forming the financing structure to block grants, which limits federal cost-sharing to a fixed amount. To understand the implications of this reform, I measure the effect of match rates on Medicaid spending by using the variation induced by a kink in the match rate formula. I find that a percentage point increase in the federal match raises per-beneficiary spending by 3 percent. Using this estimate, I discuss the welfare impact of a block grant reform.

Suggested Citation

  • Pauline Leung, 2021. "State Responses to Federal Matching Grants: The Case of Medicaid," Working Papers 647, Princeton University, Department of Economics, Industrial Relations Section..
    • Handle: RePEc:pri:indrel:647
    as

    Download full text from publisher

    File URL: https://dataspace.princeton.edu/bitstream/88435/dsp01dr26z1451/3/647.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. David Card & David S. Lee & Zhuan Pei & Andrea Weber, 2015. "Inference on Causal Effects in a Generalized Regression Kink Design," Econometrica, Econometric Society, vol. 83, pages 2453-2483, November.
    2. Congressional Budget Office, 2020. "Baseline Budget Projections as of March 6, 2020," Reports 56268, Congressional Budget Office.
    3. Chernick, Howard, 2000. "Federal Grants and Social Welfare Spending: Do State Responses Matter?," National Tax Journal, National Tax Association, vol. 53(n. 1), pages 143-52, March.
    4. Zhuan Pei & David S. Lee & David Card & Andrea Weber, 2022. "Local Polynomial Order in Regression Discontinuity Designs," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 40(3), pages 1259-1267, June.
    5. David S. Lee & Thomas Lemieux, 2010. "Regression Discontinuity Designs in Economics," Journal of Economic Literature, American Economic Association, vol. 48(2), pages 281-355, June.
    6. David Card & David S. Lee & Zhuan Pei & Andrea Weber, 2017. "Regression Kink Design: Theory and Practice," Advances in Econometrics, in: Regression Discontinuity Designs, volume 38, pages 341-382, Emerald Group Publishing Limited.
    7. Orr, Larry L, 1976. "Income Transfers as a Public Good: An Application to AFDC," American Economic Review, American Economic Association, vol. 66(3), pages 359-371, June.
    8. Brown, Charles C. & Oates, Wallace E., 1987. "Assistance to the poor in a federal system," Journal of Public Economics, Elsevier, vol. 32(3), pages 307-330, April.
    9. François Bourguignon & Amedeo Spadaro, 2012. "Tax–benefit revealed social preferences," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 10(1), pages 75-108, March.
    10. Jeffrey Clemens & Benedic Ippolito, 2018. "Implications of Medicaid Financing Reform for State Government Budgets," Tax Policy and the Economy, University of Chicago Press, vol. 32(1), pages 135-172.
    11. Edward M. Gramlich & Deborah S. Laren, 1984. "Migration and Income Redistribution Responsibilities," Journal of Human Resources, University of Wisconsin Press, vol. 19(4), pages 489-511.
    12. Baicker, Katherine & Clemens, Jeffrey & Singhal, Monica, 2012. "The rise of the states: U.S. fiscal decentralization in the postwar period," Journal of Public Economics, Elsevier, vol. 96(11), pages 1079-1091.
    13. Chernick, Howard, 2000. "Federal Grants and Social Welfare Spending: Do State Responses Matter?," National Tax Journal, National Tax Association;National Tax Journal, vol. 53(1), pages 143-152, March.
    14. Wildasin, David E, 1991. "Income Redistribution in a Common Labor Market," American Economic Review, American Economic Association, vol. 81(4), pages 757-774, September.
    15. Moffitt, Robert, 1990. "Has State Redistribution Policy Grown More Conservative?," National Tax Journal, National Tax Association;National Tax Journal, vol. 43(2), pages 123-142, June.
    16. Imbens, Guido W. & Lemieux, Thomas, 2008. "Regression discontinuity designs: A guide to practice," Journal of Econometrics, Elsevier, vol. 142(2), pages 615-635, February.
    17. Gordon, Roger H. & Cullen, Julie Berry, 2012. "Income redistribution in a Federal system of governments," Journal of Public Economics, Elsevier, vol. 96(11), pages 1100-1109.
    18. Baicker, Katherine, 2001. "Government decision-making and the incidence of federal mandates," Journal of Public Economics, Elsevier, vol. 82(2), pages 147-194, November.
    19. David C. Ribar & Mark O. Wilhelm, 1999. "The Demand for Welfare Generosity," The Review of Economics and Statistics, MIT Press, vol. 81(1), pages 96-108, February.
    20. Pauly, Mark V., 1973. "Income redistribution as a local public good," Journal of Public Economics, Elsevier, vol. 2(1), pages 35-58, February.
    21. Moffitt, Robert A., 1984. "The effects of grants-in-aid on state and local expenditures : The case of AFDC," Journal of Public Economics, Elsevier, vol. 23(3), pages 279-305, April.
    22. Marton, James & Wildasin, David E., 2007. "State government cash and in-kind benefits: Intergovernmental fiscal transfers and cross-program substitution," Journal of Urban Economics, Elsevier, vol. 61(1), pages 1-20, January.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Leung, Pauline, 2022. "State responses to federal matching grants: The case of medicaid," Journal of Public Economics, Elsevier, vol. 216(C).
    2. Marton, James & Wildasin, David E., 2007. "State government cash and in-kind benefits: Intergovernmental fiscal transfers and cross-program substitution," Journal of Urban Economics, Elsevier, vol. 61(1), pages 1-20, January.
    3. Moffitt, Robert & Ribar, David & Wilhelm, Mark, 1998. "The decline of welfare benefits in the U.S.: the role of wage inequality," Journal of Public Economics, Elsevier, vol. 68(3), pages 421-452, June.
    4. Howard Chernick, 1998. "Fiscal Effects of Block Grants for the Needy: An Interpretation of the Evidence," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 5(2), pages 205-233, May.
    5. Smith, Mark W, 1999. "Should we expect a race to the bottom in welfare benefits? Evidence from a multistate panel, 1979-1995," MPRA Paper 10125, University Library of Munich, Germany.
    6. Kettlewell, Nathan & Siminski, Peter, 2020. "Optimal Model Selection in RDD and Related Settings Using Placebo Zones," IZA Discussion Papers 13639, Institute of Labor Economics (IZA).
    7. Fiva, Jon H. & Rattso, Jorn, 2006. "Welfare competition in Norway: Norms and expenditures," European Journal of Political Economy, Elsevier, vol. 22(1), pages 202-222, March.
    8. Luis Ayala & Elena Bárcena-Martín & Jorge Martínez-Vázquez, 2022. "Devolution in the U.S. Welfare Reform: Divergence and Degradation in State Benefits," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 20(3), pages 701-726, September.
    9. Katherine Baicker, 2001. "Extensive or Intensive Generosity? The Price and Income Effects of Federal Grants," NBER Working Papers 8384, National Bureau of Economic Research, Inc.
    10. Quigley, John M. & Rubinfeld, Daniel L., 1996. "Federalism and Reductions in the Federal Budget," National Tax Journal, National Tax Association;National Tax Journal, vol. 49(2), pages 289-302, June.
    11. Saavedra, Luz Amparo, 2000. "A Model of Welfare Competition with Evidence from AFDC," Journal of Urban Economics, Elsevier, vol. 47(2), pages 248-279, March.
    12. Luis Ayala & Ana Herrero & Jorge Martinez-Vazquez, 2019. "Welfare Benefits in Highly Decentralized Fiscal Systems: Evidence on Interterritorial Mimicking," International Center for Public Policy Working Paper Series, at AYSPS, GSU paper1905, International Center for Public Policy, Andrew Young School of Policy Studies, Georgia State University.
    13. Busaba, Walid Y. & Restrepo, Felipe, 2022. "The “7% solution” and IPO (under)pricing," Journal of Financial Economics, Elsevier, vol. 144(3), pages 953-971.
    14. Lunder, Trond Erik, 2016. "Between centralized and decentralized welfare policy: Have national guidelines constrained the influence of local preferences?," European Journal of Political Economy, Elsevier, vol. 41(C), pages 1-13.
    15. Baker, Michael & Payne, A. Abigail & Smart, Michael, 1999. "An empirical study of matching grants: the 'cap on CAP'," Journal of Public Economics, Elsevier, vol. 72(2), pages 269-288, May.
    16. Gundersen, Craig & LeBlanc, Michael & Kuhn, Betsey A., 1999. "The Changing Food Assistance Landscape: The Food Stamp Program in a Post-Welfare Reform Environment," Agricultural Economic Reports 33993, United States Department of Agriculture, Economic Research Service.
    17. Boadway, Robin & Tremblay, Jean-François, 2012. "Reassessment of the Tiebout model," Journal of Public Economics, Elsevier, vol. 96(11), pages 1063-1078.
    18. Wheaton, William C., 2000. "Decentralized Welfare: Will There Be Underprovision?," Journal of Urban Economics, Elsevier, vol. 48(3), pages 536-555, November.
    19. Parviainen, Seija, 1998. "Redistribution and Risk Sharing in EMU," Discussion Papers 159, VATT Institute for Economic Research.
    20. Haitian Xie, 2022. "Nonlinear and Nonseparable Structural Functions in Fuzzy Regression Discontinuity Designs," Papers 2204.08168, arXiv.org, revised Jul 2022.

    More about this item

    Keywords

    Financial Management Reports; FMR; Centers for Medicare and Medicaid Services;
    All these keywords.

    JEL classification:

    • H77 - Public Economics - - State and Local Government; Intergovernmental Relations - - - Intergovernmental Relations; Federalism
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • H53 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Welfare Programs

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:pri:indrel:647. See general information about how to correct material in RePEc.

    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 CitEc recognized a bibliographic reference but did not link an item in RePEc 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 RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Bobray Bordelon (email available below). General contact details of provider: https://edirc.repec.org/data/irprius.html .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.