IDEAS home Printed from https://ideas.repec.org/a/bla/buecrs/v75y2023i4p1344-1361.html
   My bibliography  Save this article

The effect of the Affordable Care Act Medicaid expansion on consumer bankruptcies

Author

Listed:
  • Maude Laberge
  • Kodjo‐Maawuegnigan Djiffa

Abstract

Medical expenses have been associated with a large proportion of consumer bankruptcies in the United States. The objective of this study is to examine the relationship between the Medicaid expansion implemented in the context of the Affordable Care Act and consumer bankruptcy, overall and by chapter filing. We used a longitudinal study design with a study period of 2008–2017. We tested three approaches: difference‐in‐differences, fixed effect panel linear regression, and triple difference. We constructed a panel dataset from 2008 to 2017 with states’ data using data from various sources on insurance, bankruptcy filings, and characteristics that may affect bankruptcy, such as income and ethnicity. The outcomes were the annual rates of consumer bankruptcies overall and by chapter at the state level. Between 2008 and 2017, the overall unadjusted bankruptcy filing rate fell from 0.36% to 0.24%. We found that the expansion was associated with a decrease in overall consumer bankruptcy varying between 0.035 and 0.039 percentage points and that the intensity of the effect was modulated by the intensity of the treatment. Results were consistent across models and suggest that the Medicaid expansion had a significant negative effect on overall bankruptcy filings and specifically on Chapter 7 filings.

Suggested Citation

  • Maude Laberge & Kodjo‐Maawuegnigan Djiffa, 2023. "The effect of the Affordable Care Act Medicaid expansion on consumer bankruptcies," Bulletin of Economic Research, Wiley Blackwell, vol. 75(4), pages 1344-1361, October.
  • Handle: RePEc:bla:buecrs:v:75:y:2023:i:4:p:1344-1361
    DOI: 10.1111/boer.12411
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/boer.12411
    Download Restriction: no

    File URL: https://libkey.io/10.1111/boer.12411?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Patryk Babiarz & Richard Widdows & Tansel Yilmazer, 2013. "Borrowing To Cope With Adverse Health Events: Liquidity Constraints, Insurance Coverage, And Unsecured Debt," Health Economics, John Wiley & Sons, Ltd., vol. 22(10), pages 1177-1198, October.
    2. Luojia Hu & Robert Kaestner & Bhashkar Mazumder & Sarah Miller & Ashley Wong, 2016. "The Effect of the Patient Protection and Affordable Care Act Medicaid Expansions on Financial Wellbeing," NBER Working Papers 22170, National Bureau of Economic Research, Inc.
    3. Bhashkar Mazumder & Sarah Miller, 2016. "The Effects of the Massachusetts Health Reform on Household Financial Distress," American Economic Journal: Economic Policy, American Economic Association, vol. 8(3), pages 284-313, August.
    4. Gross, Tal & Notowidigdo, Matthew J., 2011. "Health insurance and the consumer bankruptcy decision: Evidence from expansions of Medicaid," Journal of Public Economics, Elsevier, vol. 95(7-8), pages 767-778, August.
    5. Igor Livshits & James MacGee & Michèle Tertilt, 2007. "Consumer Bankruptcy: A Fresh Start," American Economic Review, American Economic Association, vol. 97(1), pages 402-418, March.
    6. David B. Gross, 2002. "An Empirical Analysis of Personal Bankruptcy and Delinquency," The Review of Financial Studies, Society for Financial Studies, vol. 15(1), pages 319-347, March.
    7. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1057-1106.
    8. Thomas G. Koch, 2014. "Bankruptcy, Medical Insurance, And A Law With Unintended Consequences," Health Economics, John Wiley & Sons, Ltd., vol. 23(11), pages 1326-1339, November.
    9. Scott Fay & Erik Hurst & Michelle J. White, 2002. "The Household Bankruptcy Decision," American Economic Review, American Economic Association, vol. 92(3), pages 706-718, June.
    10. Ian Domowitz & Robert L. Sartain, 1999. "Determinants of the Consumer Bankruptcy Decision," Journal of Finance, American Finance Association, vol. 54(1), pages 403-420, February.
    11. Katherine Baird, 2016. "Paying ‘Til it Hurts: High Medical Spending among the Poor and Elderly in Ten Developed Countries," LIS Working papers 659, LIS Cross-National Data Center in Luxembourg.
    12. Cornwell, Christopher & Xu, Bing, 2014. "Effects of the BAPCPA on the chapter composition of consumer bankruptcies," Economics Letters, Elsevier, vol. 124(3), pages 439-442.
    13. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2017. "Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non‐Expansion States," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(1), pages 178-210, 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. Hülya Eraslan & Gizem Koşar & Wenli Li & Pierre‐Daniel Sarte, 2017. "An Anatomy Of U.S. Personal Bankruptcy Under Chapter 13," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 58(3), pages 671-702, August.
    2. Danisewicz, Piotr & Elard, Ilaf, 2023. "The real effects of financial technology: Marketplace lending and personal bankruptcy," Journal of Banking & Finance, Elsevier, vol. 155(C).
    3. Gan, Li & Hernandez, Manuel A. & Zhang, Shuoxun, 2021. "Insurance or deliberate use of the bankruptcy law for financial gain? Testing for heterogeneous filing behaviors in the United States," Economic Modelling, Elsevier, vol. 105(C).
    4. Igor Livshits & James MacGee & Michèle Tertilt, 2010. "Accounting for the Rise in Consumer Bankruptcies," American Economic Journal: Macroeconomics, American Economic Association, vol. 2(2), pages 165-193, April.
    5. Sarah Miller & Luojia Hu & Robert Kaestner & Bhashkar Mazumder & Ashley Wong, 2021. "The ACA Medicaid Expansion in Michigan and Financial Health," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(2), pages 348-375, March.
    6. Jaromir Nosal & Stefania Albanesi, 2014. "Bankruptcy, Delinquency and Debt after the 2005 Bankruptcy Law," 2014 Meeting Papers 740, Society for Economic Dynamics.
    7. Wenli Li & Pierre-Daniel G. Sarte, 2002. "The macroeconomics of U.S. consumer bankruptcy choice : chapter 7 or chapter 13?," Working Paper 02-01, Federal Reserve Bank of Richmond.
    8. Lindsey Rose Bullinger, 2021. "Child Support and the Affordable Care Act's Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(1), pages 42-77, January.
    9. Jonathan Bauchet & David Evans, 2019. "Personal Bankruptcy Determinants Among U.S. Households During the Peak of the Great Recession," Journal of Family and Economic Issues, Springer, vol. 40(4), pages 577-591, December.
    10. Owen (O.A.) O'Donnell, 2019. "Financial Protection Against Medical Expense," Tinbergen Institute Discussion Papers 19-010/V, Tinbergen Institute.
    11. Patryk Babiarz & Tansel Yilmazer, 2017. "The impact of adverse health events on consumption: Understanding the mediating effect of income transfers, wealth, and health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1743-1758, December.
    12. Diann Moorman & Steven Garasky, 2008. "Consumer Debt Repayment Behavior as a Precursor to Bankruptcy," Journal of Family and Economic Issues, Springer, vol. 29(2), pages 219-233, June.
    13. Masanori Kuroki, 2021. "The effect of health insurance coverage on personal bankruptcy: evidence from the Medicaid expansion," Review of Economics of the Household, Springer, vol. 19(2), pages 429-451, June.
    14. Song Han & Geng Li, 2011. "Household Borrowing after Personal Bankruptcy," Journal of Money, Credit and Banking, Blackwell Publishing, vol. 43, pages 491-517, March.
    15. Igor Livshits, 2015. "Recent Developments In Consumer Credit And Default Literature," Journal of Economic Surveys, Wiley Blackwell, vol. 29(4), pages 594-613, September.
    16. Gallagher, Emily A. & Gopalan, Radhakrishnan & Grinstein-Weiss, Michal & Sabat, Jorge, 2020. "Medicaid and household savings behavior: New evidence from tax refunds," Journal of Financial Economics, Elsevier, vol. 136(2), pages 523-546.
    17. Gallagher, Emily A. & Gopalan, Radhakrishnan & Grinstein-Weiss, Michal, 2019. "The effect of health insurance on home payment delinquency: Evidence from ACA Marketplace subsidies," Journal of Public Economics, Elsevier, vol. 172(C), pages 67-83.
    18. Patrick Richard & Nilam Patel & Yuan-Chiao Lu & Regine Walker & Mustafa Younis, 2021. "The Financial Burden of Cancer on Families in the United States," IJERPH, MDPI, vol. 18(7), pages 1-14, April.
    19. Argys, Laura M. & Friedson, Andrew I. & Pitts, M. Melinda & Tello-Trillo, D. Sebastian, 2020. "Losing public health insurance: TennCare reform and personal financial distress," Journal of Public Economics, Elsevier, vol. 187(C).
    20. Li, Wenli & Sarte, Pierre-Daniel, 2006. "U.S. consumer bankruptcy choice: The importance of general equilibrium effects," Journal of Monetary Economics, Elsevier, vol. 53(3), pages 613-631, April.

    More about this item

    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:bla:buecrs:v:75:y:2023:i:4:p:1344-1361. 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: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0307-3378 .

    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.