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Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low Income Children

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Author Info
David Card
Lara D. Shore-Sheppard

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Abstract

This paper exploits the discrete nature of the eligibility criteria for two major federal expansions of Medicaid to measure the effects on Medicaid coverage, overall health insurance coverage, and the probability of visiting a doctor. The '100 percent' expansion, effective in 1991, extended Medicaid eligibility to children born after September 30, 1983 in families below the poverty line. We estimate that this law led to about a 10 percentage point rise in Medicaid coverage for children born just after the cutoff date, and a similar or slightly smaller rise in overall health insurance. It also increased the fraction of children in the newly eligible group with a doctor visit in the previous year. The '133 percent' expansion, effective in 1990, extended Medicaid to children under 6 in families with incomes below 133 percent of the poverty line. This law had relatively small effects on Medicaid coverage for children near the eligibility limits, and little or no effect on health insurance coverage.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 9058.

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Date of creation: Jul 2002
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Handle: RePEc:nbr:nberwo:9058

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Find related papers by JEL classification:
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
I38 - Health, Education, and Welfare - - Welfare and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

References listed on IDEAS
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  1. Lara Shore-Sheppard, 1996. "The Effects of Expanding Medicaid Eligibility on the Distribution of Children's Health Insurance Coverage," Working Papers 748, Princeton University, Department of Economics, Industrial Relations Section.. [Downloadable!]
  2. Angrist, Joshua D. & Krueger, Alan B., 1999. "Empirical strategies in labor economics," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 23, pages 1277-1366 Elsevier. [Downloadable!] (restricted)
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  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. [Downloadable!] (restricted)
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  4. Pischke, Jorn-Steffen, 1995. "Individual Income, Incomplete Information, and Aggregate Consumption," Econometrica, Econometric Society, vol. 63(4), pages 805-40, July. [Downloadable!] (restricted)
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  5. Esel Y. Yazici & Robert Kaestner, 1998. "Medicaid Expansions and The Crowding Out of Private Health Insurance," NBER Working Papers 6527, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  6. 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.
  7. 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. [Downloadable!] (restricted)
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  8. John C. Ham & Lara D. Shore-Sheppard, 2001. "The Effect of Medicaid Expansions for Low-Income Children on Medicaid Participation and Insurance Coverage: Evidence from the SIPP," NBER Working Papers 8063, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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Cited by:
(explanations, 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.)

  1. Anna Aizer, 2006. "Public Health Insurance, Program Take-Up, and Child Health," NBER Working Papers 12105, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  2. Thomas DeLeire & Leonard M. Lopoo & Kosali I. Simon, 2007. "Medicaid Expansions and Fertility in the United States," NBER Working Papers 12907, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  3. Reagan Baughman, 2007. "Differential impacts of public health insurance expansions at the local level," International Journal of Health Care Finance and Economics, Springer, vol. 7(1), pages 1-22, March. [Downloadable!] (restricted)
  4. David S. Lee & Thomas Lemieux, 2009. "Regression Discontinuity Designs in Economics," NBER Working Papers 14723, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  5. Richard Blundell & Mónica Costa Dias, 2008. "Alternative Approaches to Evaluation in Empirical Microeconomics," CETE Discussion Papers 0805, Universidade do Porto, Faculdade de Economia do Porto. [Downloadable!]
    Other versions:
  6. Elisabetta Trevisan, 2008. "Enforcement of Employment Protection and the hiring behaviour of firms. Evidence from a large Italian region," Working Papers 2008_25, University of Venice "Ca' Foscari", Department of Economics. [Downloadable!]
  7. repec:bep:eapadv:v:8:y:2008:i:2:p:1835-1835 is not listed on IDEAS
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  8. 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. [Downloadable!] (restricted)
  9. David S. Lee & David Card, 2006. "Regression Discontinuity Inference with Specification Error," NBER Technical Working Papers 0322, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
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