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Using the Medicare Buy-In Program to Estimate the Effect of Medicaid on SSI Participation

  • A. S. Yelowitz

This paper assesses the importance of receiving public health insurance through the Medicaid program on participation in Supplemental Security Income (SSI) for the elderly. The implementation of the Qualified Medicare Beneficiary (QMB) program offered a substitute for the Medicaid coverage, and expanded health insurance eligibility to a higher income level than SSI. Although the QMB program offered an alternative health insurance source (which may reduce SSI participation), its introduction may have increased awareness about the SSI program (and hence, participation). I find that the net effect was to reduce SSI participation. The effects were particularly strong for African Americans and for those with less than a high school diploma. Roughly half of the QMB participants were previously covered by SSI and Medicaid. The calculations suggest that the QMB program was not as expensive as it might first appear because of reductions in SSI expenditure.

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Paper provided by University of Wisconsin Institute for Research on Poverty in its series Institute for Research on Poverty Discussion Papers with number 1102-96.

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Handle: RePEc:wop:wispod:1102-96
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  1. Aaron Yelowitz, 1995. "The Medicaid Notch, Labor Supply and Welfare Participation: Evidence from Eligibility Expansions," UCLA Economics Working Papers 738, UCLA Department of Economics.
  2. Hubbard, R Glenn & Skinner, Jonathan & Zeldes, Stephen P, 1995. "Precautionary Saving and Social Insurance," Journal of Political Economy, University of Chicago Press, vol. 103(2), pages 360-99, April.
  3. Currie, Janet & Gruber, Jonathan, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, MIT Press, vol. 111(2), pages 431-66, May.
  4. McGarry, K & Schoeni, R-F, 1996. "Measurement and the Redistribution of Resources Within the Family," Papers 96-11, RAND - Reprint Series.
  5. B. Wolfe & S. C. Hill, . "The effect of health on the work effort of low-income single mothers," Institute for Research on Poverty Discussion Papers 979-92, University of Wisconsin Institute for Research on Poverty.
  6. Yelowitz, Aaron S., 1998. "Why did the SSI-disabled program grow so much? Disentangling the effect of Medicaid," Journal of Health Economics, Elsevier, vol. 17(3), pages 321-349, June.
  7. James M. Poterba & Steven F. Venti & David A. Wise, 1993. "Do 401(k) Contributions Crowd Out Other Persoanl Saving?," NBER Working Papers 4391, National Bureau of Economic Research, Inc.
  8. Barbara L. Wolfe & Steven C. Hill, 1995. "The Effect of Health on the Work Effort of Single Mothers," Journal of Human Resources, University of Wisconsin Press, vol. 30(1), pages 42-62.
  9. Gruber, J. & Currie, J., 1994. "Saving Babies: The Efficacy and Cost of Recent Expansions of Medicaid Eligibility for Pregnant Women," Working papers 94-11, Massachusetts Institute of Technology (MIT), Department of Economics.
  10. Douglas Holtz-Eakin, 1994. "Health Insurance Provision and Labor Market Efficiency in the United States and Germany," NBER Chapters, in: Social Protection versus Economic Flexibility: Is There a Trade-Off?, pages 157-188 National Bureau of Economic Research, Inc.
  11. Kathleen McGarry, 1995. "Factors Determining Participation of the Elderly in SSI," NBER Working Papers 5250, National Bureau of Economic Research, Inc.
  12. Jonathan Gruber & Brigitte C. Madrian, 1994. "Health insurance and job mobility: The effects of public policy on job-lock," Industrial and Labor Relations Review, ILR Review, Cornell University, ILR School, vol. 48(1), pages 86-102, October.
  13. Hill, Daniel H, 1990. "An Endogenously-Switching Ordered-Response Model of Information, Eligibility and Participation in SSI," The Review of Economics and Statistics, MIT Press, vol. 72(2), pages 368-71, May.
  14. 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.
  15. Gruber, J. & Madrian, B.C., 1994. "Health Insurance Availability and the Retirement Decision," Working papers 94-04, Massachusetts Institute of Technology (MIT), Department of Economics.
  16. Moffitt, Robert, 1983. "An Economic Model of Welfare Stigma," American Economic Review, American Economic Association, vol. 73(5), pages 1023-35, December.
  17. Moulton, Brent R., 1986. "Random group effects and the precision of regression estimates," Journal of Econometrics, Elsevier, vol. 32(3), pages 385-397, August.
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