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Understanding the Impact of Health Reform on the States: Expansion of Coverage through Medicaid and Exchanges

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  • LILLIARD E. RICHARDSON
  • TANSEL YILMAZER

Abstract

type="main"> The Affordable Care Act (ACA) expands Medicaid coverage and creates subsidized state health insurance exchanges. The implementation of the ACA will impact the states and consequently the state residents differently. We discuss the factors contributing to the variation in uninsured rates and the Medicaid population, and we predict that these underlying economic, demographic factors and state policies will continue to affect health insurance coverage. Using data from the March 2010 Current Population Survey (CPS), we examine health care coverage at the state level prior to the ACA and forecast the percentage of state residents eligible for expanded Medicaid and the exchanges. Our results suggest the percentage of state population eligible for expanded Medicaid and subsidized exchanges will vary considerably, especially for adults. Further, we show that current state Medicaid eligibility rules, the percentage of employers offering health insurance and poverty rates will continue to shape the variation in projected health insurance coverage across the states. Finally, we discuss the potential impact of the Supreme Court decision that allowed states to opt-out of Medicaid expansion.

Suggested Citation

  • Lilliard E. Richardson & Tansel Yilmazer, 2013. "Understanding the Impact of Health Reform on the States: Expansion of Coverage through Medicaid and Exchanges," Journal of Consumer Affairs, Wiley Blackwell, vol. 47(2), pages 191-218, July.
    • Handle: RePEc:bla:jconsa:v:47:y:2013:i:2:p:191-218
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    File URL: http://hdl.handle.net/10.1111/joca.12005
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    References listed on IDEAS

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    1. Sommers, Benjamin D., 2010. "Targeting in Medicaid: The costs and enrollment effects of Medicaid's citizenship documentation requirement," Journal of Public Economics, Elsevier, vol. 94(1-2), pages 174-182, February.
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    Cited by:

    1. Sharon A. DeVaney, 2016. "Fifty Years of Consumer Issues in The Journal of Consumer Affairs," Journal of Consumer Affairs, Wiley Blackwell, vol. 50(3), pages 505-514, November.
    2. Kurt Lavetti & Thomas DeLeire & Nicolas R. Ziebarth, 2023. "How do low‐income enrollees in the Affordable Care Act marketplaces respond to cost‐sharing?," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 90(1), pages 155-183, March.
    3. Lingxiao Wang & Yuqing Zheng & Steven C. Buck, 2021. "How does the affordable care act Medicaid expansion affect cigarette consumption?—The mechanism and heterogeneity," Journal of Consumer Affairs, Wiley Blackwell, vol. 55(3), pages 763-791, September.
    4. M. Paula Fitzgerald & Thomas K. Bias, 2016. "Satisfaction and Repurchase Intentions for Health Insurance Marketplaces: Evidence from a Partnership State," Journal of Consumer Affairs, Wiley Blackwell, vol. 50(3), pages 638-651, November.
    5. M. Paula Fitzgerald & Thomas K. Bias & Tami Gurley-Calvez, 2017. "The Affordable Care Act and Consumer Well-Being: Knowns and Unknowns," Journal of Consumer Affairs, Wiley Blackwell, vol. 51(1), pages 27-53, March.

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