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Medicaid expansions for the working age disabled: Revisiting the crowd-out of private health insurance

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  • Wagner, Kathryn L.

Abstract

Disabled individuals under 65 years old account for 15% of Medicaid recipients but half of all Medicaid spending. Despite their large cost, few studies have investigated the effects of Medicaid expansions for disabled individuals on insurance coverage and crowd-out of private insurance. Using an eligibility expansion that allowed states to provide Medicaid to disabled individuals with incomes less than 100% of the federal poverty level, I address these issues. Crowd-out estimates range from 49% using an ordinary least squares procedure to 100% using two-stage least-squares analysis. This potentially large degree of crowd-out could have fiscal implications for the Affordable Care Act which has greatly expanded Medicaid eligibility in 2014.

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  • Wagner, Kathryn L., 2015. "Medicaid expansions for the working age disabled: Revisiting the crowd-out of private health insurance," Journal of Health Economics, Elsevier, vol. 40(C), pages 69-82.
    • Handle: RePEc:eee:jhecon:v:40:y:2015:i:c:p:69-82
    DOI: 10.1016/j.jhealeco.2014.12.007
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    Cited by:

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    2. Heim, Bradley & Lurie, Ithai & Mullen, Kathleen J. & Simon, Kosali, 2021. "How Much Do Outside Options Matter? The Effect of Subsidized Health Insurance on Social Security Disability Insurance Benefit Receipt," Journal of Health Economics, Elsevier, vol. 76(C).
    3. Jun Yeong Lee & John V. Winters, 2022. "State Medicaid Expansion and the Self-Employed," Small Business Economics, Springer, vol. 59(3), pages 925-954, October.
    4. Lieber, Ethan M.J., 2018. "Does health insurance coverage fall when nonprofit insurers become for-profits?," Journal of Health Economics, Elsevier, vol. 57(C), pages 75-88.
    5. Ellis, Cameron M. & Esson, Meghan I., 2021. "Crowd-Out and Emergency Department Utilization," Journal of Health Economics, Elsevier, vol. 80(C).
    6. Lee, Daeyong & (Alicia) Zhang, Fan, 2017. "Impact of the Medicaid expansion on U.S. health services firms: Evidence from the 2010 Affordable Care Act," Finance Research Letters, Elsevier, vol. 21(C), pages 172-177.
    7. Sezen O. Onal, 2024. "Heterogeneity in crowd‐out by risk aversion: Assessing the effect of the ACA Medicaid expansion," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 27(2), pages 137-160, June.
    8. Ali Moghtaderi & Jesse Pines & Mark Zocchi & Bernard Black, 2020. "The effect of Affordable Care Act Medicaid expansion on hospital revenue," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1682-1704, December.
    9. Aparna Soni, 2022. "The impact of the repeal of the federal individual insurance mandate on uninsurance," International Journal of Health Economics and Management, Springer, vol. 22(4), pages 423-441, December.
    10. Jason Semprini, 2023. "Medicaid expansions and private insurance “crowd‐out” (1999–2019)," Social Science Quarterly, Southwestern Social Science Association, vol. 104(7), pages 1329-1342, December.
    11. Wagner, Kathryn L., 2016. "Shock, but no shift: Hospitals' responses to changes in patient insurance mix," Journal of Health Economics, Elsevier, vol. 49(C), pages 46-58.
    12. Pinka Chatterji & Yue Li, 2016. "Early Effects of the 2010 Affordable Care Act Medicaid Expansions on Federal Disability Program Participation," NBER Working Papers 22531, National Bureau of Economic Research, Inc.
    13. Wagner Kathryn L., 2021. "Public Health Insurance and Impacts on Crime Incidences and Mental Health," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 21(2), pages 469-510, April.

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    More about this item

    Keywords

    Medicaid expansions; Health insurance; Crowd-out; Disability; Public programs;
    All these keywords.

    JEL classification:

    • H4 - Public Economics - - Publicly Provided Goods
    • I1 - Health, Education, and Welfare - - Health

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