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Out of the Woodwork: Enrollment Spillovers in the Oregon Health Insurance Experiment

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  • Adam Sacarny
  • Katherine Baicker
  • Amy Finkelstein

Abstract

We study the impact of expanded adult Medicaid eligibility on the enrollment of already-eligible children. We analyze the 2008 Oregon Medicaid lottery, in which some low-income uninsured adults were randomly selected to be allowed to apply for Medicaid. Children in these households were eligible for Medicaid irrespective of the lottery outcome. We estimate statistically significant but transitory impacts of adult lottery selection on child Medicaid enrollment: at three months after the lottery, for every nine adults who enrolled in Medicaid due to winning the lottery, one additional child also enrolled. Our results shed light on the existence, magnitude, and nature of so-called "woodwork effects."

Suggested Citation

  • Adam Sacarny & Katherine Baicker & Amy Finkelstein, 2022. "Out of the Woodwork: Enrollment Spillovers in the Oregon Health Insurance Experiment," American Economic Journal: Economic Policy, American Economic Association, vol. 14(3), pages 273-295, August.
    • Handle: RePEc:aea:aejpol:v:14:y:2022:i:3:p:273-95
    DOI: 10.1257/pol.20200172
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    References listed on IDEAS

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    1. Manasi Deshpande & Yue Li, 2019. "Who Is Screened Out? Application Costs and the Targeting of Disability Programs," American Economic Journal: Economic Policy, American Economic Association, vol. 11(4), pages 213-248, November.
    2. Amy Finkelstein & Matthew J Notowidigdo, 2019. "Take-Up and Targeting: Experimental Evidence from SNAP," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(3), pages 1505-1556.
    3. Anna Aizer, 2003. "Low Take-Up in Medicaid: Does Outreach Matter and for Whom?," American Economic Review, American Economic Association, vol. 93(2), pages 238-241, May.
    4. Anna Aizer & Jeffrey Grogger, 2003. "Parental Medicaid Expansions and Health Insurance Coverage," NBER Working Papers 9907, National Bureau of Economic Research, Inc.
    5. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 391-430.
    6. Baicker, Katherine & Finkelstein, Amy, 2019. "The Impact of Medicaid Expansion on Voter Participation: Evidence from the Oregon Health Insurance Experiment," Quarterly Journal of Political Science, now publishers, vol. 14(4), pages 383-400, October.
    7. Katherine Baicker & Amy Finkelstein & Jae Song & Sarah Taubman, 2014. "The Impact of Medicaid on Labor Market Activity and Program Participation: Evidence from the Oregon Health Insurance Experiment," American Economic Review, American Economic Association, vol. 104(5), pages 322-328, May.
    8. Saurabh Bhargava & Dayanand Manoli, 2015. "Psychological Frictions and the Incomplete Take-Up of Social Benefits: Evidence from an IRS Field Experiment," American Economic Review, American Economic Association, vol. 105(11), pages 3489-3529, November.
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    Cited by:

    1. Timothy J. Halliday & Randall Q. Akee, 2020. "The impact of Medicaid on medical utilization in a vulnerable population: Evidence from COFA migrants," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1231-1250, October.
    2. Liyang Sun, 2021. "Empirical Welfare Maximization with Constraints," Papers 2103.15298, arXiv.org, revised Sep 2024.
    3. Lipton, Brandy J., 2021. "Adult Medicaid benefit generosity and receipt of recommended health services among low-income children: The spillover effects of Medicaid adult dental coverage expansions," Journal of Health Economics, Elsevier, vol. 75(C).
    4. Shooshan Danagoulian & Daniel Grossman & David Slusky, 2022. "Health Care Following Environmental Disasters: Evidence from Flint," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 41(4), pages 1060-1089, September.
    5. Liam Sigaud & Markus Bjoerkheim & Vitor Melo, 2024. "The Hidden Subsidy of the Affordable Care Act," Papers 2407.07217, arXiv.org.

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    More about this item

    JEL classification:

    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth

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