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The Effects of State Medicaid Expansions for Working-Age Adults on Senior Medicare Beneficiaries

Author

Listed:
  • Melissa McInerney
  • Jennifer M. Mellor
  • Lindsay M. Sabik

Abstract

Do Medicaid expansions to working-age adults affect healthcare spending and utilization among older Medicare beneficiaries? Although economic theory provides conflicting predictions about the presence and direction of such spillover effects, it does identify circumstances when spillovers can reduce Medicare spending. Using data on Medicaid expansions during the 2000s and microdata from the Medicare Current Beneficiary Survey, we find that a 1 percentage point rise in the share of working-age adults eligible for Medicaid has modest effects on the average Medicare beneficiary's spending, but reduces average spending by $477 among dual eligibles. Importantly, we find no evidence of adverse health effects.

Suggested Citation

  • Melissa McInerney & Jennifer M. Mellor & Lindsay M. Sabik, 2017. "The Effects of State Medicaid Expansions for Working-Age Adults on Senior Medicare Beneficiaries," American Economic Journal: Economic Policy, American Economic Association, vol. 9(3), pages 408-438, August.
    • Handle: RePEc:aea:aejpol:v:9:y:2017:i:3:p:408-38
    Note: DOI: 10.1257/pol.20150402
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    Citations

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    Cited by:

    1. Dunn, Abe & Knepper, Matthew & Dauda, Seidu, 2021. "Insurance expansions and hospital utilization: Relabeling and reabling?," Journal of Health Economics, Elsevier, vol. 78(C).
    2. Barkowski, Scott & Jun, Dajung & Zhang, Yuting, 2022. "Medicaid Expansion Spillover Effects on Health Care Consumption and Coverage: Evidence from Medicare Administrative Data," MPRA Paper 112178, University Library of Munich, Germany.
    3. Melissa McInerney & Jennifer M. Mellor & Lindsay M. Sabik, 2021. "Welcome Mats and On‐Ramps for Older Adults: The Impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(1), pages 12-41, January.
    4. Neprash, Hannah T. & Zink, Anna & Sheridan, Bethany & Hempstead, Katherine, 2021. "The effect of Medicaid expansion on Medicaid participation, payer mix, and labor supply in primary care," Journal of Health Economics, Elsevier, vol. 80(C).
    5. Colleen M. Carey & Sarah Miller & Laura R. Wherry, 2020. "The Impact of Insurance Expansions on the Already Insured: The Affordable Care Act and Medicare," American Economic Journal: Applied Economics, American Economic Association, vol. 12(4), pages 288-318, October.
    6. Dillender, Marcus & Jinks, Lu & Lo Sasso, Anthony T., 2023. "When (and why) providers do not respond to changes in reimbursement rates," Journal of Public Economics, Elsevier, vol. 217(C).
    7. Colleen Heflin & Jun Li & Dongmei Zuo, 2023. "Changing patterns of SNAP take‐up and participation and the role of out‐of‐pocket medical expenses among older adults," Applied Economic Perspectives and Policy, John Wiley & Sons, vol. 45(1), pages 336-349, March.
    8. Glied, Sherry & Hong, Kai, 2018. "Health care in a multi-payer system: Spillovers of health care service demand among adults under 65 on utilization and outcomes in medicare," Journal of Health Economics, Elsevier, vol. 60(C), pages 165-176.
    9. Kole Reddig, 2024. "Spillover between Medicare and Medicaid: Evidence from decreasing physician reimbursements," Contemporary Economic Policy, Western Economic Association International, vol. 42(2), pages 223-236, April.
    10. Cathy J. Bradley & Lindsay M. Sabik, 2019. "Medicaid expansions and labor supply among low-income childless adults: evidence from 2000 to 2013," International Journal of Health Economics and Management, Springer, vol. 19(3), pages 235-272, December.
    11. Geruso, Michael & Richards, Michael R., 2022. "Trading spaces: Medicare's regulatory spillovers on treatment setting for non-Medicare patients," Journal of Health Economics, Elsevier, vol. 84(C).

    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
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • 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
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

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