IDEAS home Printed from https://ideas.repec.org/a/eee/regeco/v49y2014icp164-178.html
   My bibliography  Save this article

Is Medicaid crowding out other state government expenditure? Internal financing and cross-program substitution

Author

Listed:
  • Craig, Steven G.
  • Howard, Larry L.

Abstract

We examine whether state government responses to rising Medicaid costs cause reduced low income assistance, overall state budget cuts, or higher taxes. We segment Medicaid recipient groups into families, the disabled, and the elderly. Using GMM estimation, we instrument for endogenous program participation using federally directed program recipients in a panel of 47 states from 1976 to 2004. We find that half of cost increases for elderly recipients are financed by own benefit decreases. We find that the disabled group increases Medicaid for all through cuts in other government expenditure, family recipients erode Medicaid benefits and cash assistance, Medicaid only for families is increased because of AFDC matching elimination, and taxpayers fund no cost increases.

Suggested Citation

  • Craig, Steven G. & Howard, Larry L., 2014. "Is Medicaid crowding out other state government expenditure? Internal financing and cross-program substitution," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 164-178.
    • Handle: RePEc:eee:regeco:v:49:y:2014:i:c:p:164-178
    DOI: 10.1016/j.regsciurbeco.2014.09.003
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0166046214001008
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.regsciurbeco.2014.09.003?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Howard Chernick, 1998. "Fiscal Effects of Block Grants for the Needy: An Interpretation of the Evidence," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 5(2), pages 205-233, May.
    2. David H. Autor & Mark G. Duggan, 2003. "The Rise in the Disability Rolls and the Decline in Unemployment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 118(1), pages 157-206.
    3. Pashardes, Panos, 1993. "Bias in Estimating the Almost Ideal Demand System with the Stone Index Approximation," Economic Journal, Royal Economic Society, vol. 103(419), pages 908-915, July.
    4. Deaton,Angus & Muellbauer,John, 1980. "Economics and Consumer Behavior," Cambridge Books, Cambridge University Press, number 9780521296762, January.
    5. Steven Craig & Robert P. Inman, 1986. "Education, Welfare and the "New" Federalism: State Budgeting in a Federalist Public Economy," NBER Chapters, in: Studies in State and Local Public Finance, pages 187-228, National Bureau of Economic Research, Inc.
    6. Erikson, Robert S. & Wright, Gerald C. & McIver, John P., 1989. "Political Parties, Public Opinion, and State Policy in the United States," American Political Science Review, Cambridge University Press, vol. 83(3), pages 729-750, September.
    7. Deacon, Robert T, 1978. "A Demand Model for the Local Public Sector," The Review of Economics and Statistics, MIT Press, vol. 60(2), pages 184-192, May.
    8. Baicker, Katherine, 2001. "Government decision-making and the incidence of federal mandates," Journal of Public Economics, Elsevier, vol. 82(2), pages 147-194, November.
    9. Plotnick, Robert D, 1986. "An Interest Group Model of Direct Income Redistribution," The Review of Economics and Statistics, MIT Press, vol. 68(4), pages 594-602, November.
    10. Peter C. Coyte & Stuart Landon, 1990. "Cost-Sharing versus Block-Funding in a Federal System: A Demand Systems Approach," Canadian Journal of Economics, Canadian Economics Association, vol. 23(4), pages 817-838, November.
    11. Larry L. Howard, 2010. "Is the Demand for Health Care Generosity Equal for All Recipients? A Longitudinal Analysis of State Medicaid Spending, 1977-2004," Public Finance Review, , vol. 38(3), pages 346-377, May.
    12. Marton, James & Wildasin, David E., 2007. "State government cash and in-kind benefits: Intergovernmental fiscal transfers and cross-program substitution," Journal of Urban Economics, Elsevier, vol. 61(1), pages 1-20, January.
    13. Arthur Lewbel, 2012. "Using Heteroscedasticity to Identify and Estimate Mismeasured and Endogenous Regressor Models," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 30(1), pages 67-80.
    14. Olsen, Randall J, 1980. "A Least Squares Correction for Selectivity Bias," Econometrica, Econometric Society, vol. 48(7), pages 1815-1820, November.
    15. Yelowitz, Aaron S., 1998. "Why did the SSI-disabled program grow so much? Disentangling the effect of Medicaid," Journal of Health Economics, Elsevier, vol. 17(3), pages 321-349, June.
    16. Alston, Julian M & Foster, Kenneth A & Green, Richard D, 1994. "Estimating Elasticities with the Linear Approximate Almost Ideal Demand System: Some Monte Carlo Results," The Review of Economics and Statistics, MIT Press, vol. 76(2), pages 351-356, May.
    17. David C. Ribar & Mark O. Wilhelm, 1999. "The Demand for Welfare Generosity," The Review of Economics and Statistics, MIT Press, vol. 81(1), pages 96-108, February.
    18. Deaton, Angus S & Muellbauer, John, 1980. "An Almost Ideal Demand System," American Economic Review, American Economic Association, vol. 70(3), pages 312-326, June.
    19. Katherine Baicker, 2005. "Extensive or Intensive Generosity? The Price and Income Effects of Federal Grants," The Review of Economics and Statistics, MIT Press, vol. 87(2), pages 371-384, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Mark Kattenberg & Wouter Vermeulen, 2018. "The stimulative effect of an unconditional block grant on the decentralized provision of care," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 25(1), pages 166-199, February.
    2. Kattenberg, Mark & Vermeulen, Wouter, 2017. "The stimulative effect of an unconditional block grant on the decentralized provision of care," LSE Research Online Documents on Economics 86956, London School of Economics and Political Science, LSE Library.
    3. Lipton, Brandy J. & Decker, Sandra L., 2016. "The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: Evidence from the National Health and Nutrition Examination Survey," Social Science & Medicine, Elsevier, vol. 150(C), pages 258-267.
    4. Mark Kattenberg & Wouter Vermeulen, 2015. "The stimulative effect of an unconditional block grant on the decentralized provision of care," CPB Discussion Paper 308, CPB Netherlands Bureau for Economic Policy Analysis.
    5. Mark Kattenberg & Wouter Vermeulen, 2016. "The Stimulative Effect of an Unconditional Block Grant on the Decentralized Provision of Care," SERC Discussion Papers 0209, Centre for Economic Performance, LSE.
    6. Mark Kattenberg & Wouter Vermeulen, 2015. "The stimulative effect of an unconditional block grant on the decentralized provision of care," CPB Discussion Paper 308.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    7. Stadhouders, Niek & Kruse, Florien & Tanke, Marit & Koolman, Xander & Jeurissen, Patrick, 2019. "Effective healthcare cost-containment policies: A systematic review," Health Policy, Elsevier, vol. 123(1), pages 71-79.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Larry L. Howard, 2010. "Is the Demand for Health Care Generosity Equal for All Recipients? A Longitudinal Analysis of State Medicaid Spending, 1977-2004," Public Finance Review, , vol. 38(3), pages 346-377, May.
    2. William A. Barnett & Ousmane Seck, 2008. "Rotterdam model versus almost ideal demand system: will the best specification please stand up?," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 23(6), pages 795-824.
    3. Sanvi Avouyi-Dovi & Christian Pfister & Franck S dillot, 2019. "French Households Portfolio: The Financial Almost Ideal Demand System Appraisal," Working papers 728, Banque de France.
    4. Leung, Pauline, 2022. "State responses to federal matching grants: The case of medicaid," Journal of Public Economics, Elsevier, vol. 216(C).
    5. William Barnett & Ousmane Seck, 2006. "Rotterdam vs Almost Ideal Models: Will the Best Demand Specification Please Stand Up?," WORKING PAPERS SERIES IN THEORETICAL AND APPLIED ECONOMICS 200605, University of Kansas, Department of Economics.
    6. Witterblad, Mikael, 2008. "Essays on Redistribution and Local Public Expenditures," Umeå Economic Studies 731, Umeå University, Department of Economics.
    7. Lars-Erik Borge & Jørn Rattsø, 1998. "Demographic Shift, Relative Costs and the Allocation of Local Public Consumption in Norway," Chapters, in: Jørn Rattsø (ed.), Fiscal Federalism and State–local Finance, chapter 5, pages 71-92, Edward Elgar Publishing.
    8. Denni Tommasi, 2016. "Household Responses to cash Transfers," Working Papers ECARES ECARES 2016-20, ULB -- Universite Libre de Bruxelles.
    9. Marton, James & Wildasin, David E., 2007. "State government cash and in-kind benefits: Intergovernmental fiscal transfers and cross-program substitution," Journal of Urban Economics, Elsevier, vol. 61(1), pages 1-20, January.
    10. Witterblad, Mikael, 2008. "The Demand for Local Public Services in Sweden," Umeå Economic Studies 730, Umeå University, Department of Economics.
    11. Cantos-Sánchez, Pedro & Gutiérrez-i-Puigarnau, Eva & Mulalic, Ismir, 2018. "The impact of scrappage programmes on the demand for new vehicles: Evidence from Spain," Research in Transportation Economics, Elsevier, vol. 70(C), pages 83-96.
    12. Douglas Fisher & Adrian R. Fleissig & Apostolos Serletis, 2006. "An Empirical Comparison of Flexible Demand System Functional Forms," World Scientific Book Chapters, in: Money And The Economy, chapter 13, pages 247-277, World Scientific Publishing Co. Pte. Ltd..
    13. Masayoshi Hayashi, 2017. "Do Central Grants Affect Welfare Caseloads? Evidence from Public Assistance in Japan," CIRJE F-Series CIRJE-F-1064, CIRJE, Faculty of Economics, University of Tokyo.
    14. Wen S. Chern & Kimiko Ishibashi & Kiyoshi Taniguchi & Yuki Tokoyama, 2002. "Analysis of Food Consumption Behavior by Japanese Households," Working Papers 02-06, Agricultural and Development Economics Division of the Food and Agriculture Organization of the United Nations (FAO - ESA).
    15. Howard Chernick, 1999. "State Fiscal Substitution Between the Federal Food Stamp Program and AFDC, Medicaid, and SSI," JCPR Working Papers 123, Northwestern University/University of Chicago Joint Center for Poverty Research.
    16. repec:ebl:ecbull:v:3:y:2008:i:14:p:1-10 is not listed on IDEAS
    17. Chia-Lin Chang & Thanchanok Khamkaew & Michael McAleer, 2010. "Estimating Price Effects in an Almost Ideal Demand Model of Outbound Thai Tourism to East Asia," Working Papers in Economics 10/11, University of Canterbury, Department of Economics and Finance.
    18. Meyerhoefer, Chad D. & Ranney, Christine K. & Sahn, David E., 2003. "Consistent Estimation Of Longitudinal Censored Demand Systems: An Application To Transition Country Data," Working Papers 127252, Cornell University, Department of Applied Economics and Management.
    19. Taniguchi, Kiyoshi & Chern, Wen S., 2000. "Income Elasticity Of Rice Demand In Japan And Its Implications: Cross-Sectional Data Analysis," 2000 Annual meeting, July 30-August 2, Tampa, FL 21755, American Agricultural Economics Association (New Name 2008: Agricultural and Applied Economics Association).
    20. Anton Bondarev, 2008. "Evaluation of Demand Functions for foodstuffs in Russian Economy in 1999–2004," Research Paper Series, Gaidar Institute for Economic Policy, issue 118P, pages 166-166.
    21. William A. Barnett & Isaac Kalonda Kanyama, 2013. "Time-varying parameters in the almost ideal demand system and the Rotterdam model: will the best specification please stand up?," Applied Economics, Taylor & Francis Journals, vol. 45(29), pages 4169-4183, October.

    More about this item

    Keywords

    State expenditure; Medicaid; Health care; Fiscal federalism;
    All these keywords.

    JEL classification:

    • H72 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Budget and Expenditures
    • H77 - Public Economics - - State and Local Government; Intergovernmental Relations - - - Intergovernmental Relations; Federalism
    • 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

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:regeco:v:49:y:2014:i:c:p:164-178. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/regec .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.