IDEAS home Printed from https://ideas.repec.org/a/kap/poprpr/v36y2017i1d10.1007_s11113-016-9414-0.html
   My bibliography  Save this article

Identifying Associations Between State Medicaid Expansion Decisions and Spatial Disparities in County Insurance Rate Changes Under the Affordable Care Act

Author

Listed:
  • Danielle Christine Rhubart

    (Wright State University)

Abstract

By the end of 2014, twenty-four states rejected Medicaid expansion, providing a unique opportunity to examine changes in insurance coverage rates after the implementation of the Affordable Care Act within and between states that did versus did not expand Medicaid. Using multilevel regression analyses of county-level non-elderly adult small area health insurance estimates (N = 3135) from the US Census Bureau, several important findings emerge. Compared to counties located in states that did not expand Medicaid, counties located in states that did expand experienced significantly larger increases in adult health insurance coverage rates between 2013 and 2014, net of the county baseline insurance coverage rate, socioeconomic and demographic composition, and labor market characteristics. In states that did not expand Medicaid, counties with larger shares of vulnerable residents (i.e., poor adults and low education) experienced lagging improvements in health insurance coverage. However, counties in states that expanded Medicaid were protected from several of these exacerbated disparities, and in some cases, experienced larger insurance coverage improvements than counties with less disadvantaged populations. These findings suggest that although insurance coverage increased in nearly all counties between 2013 and 2014, increases would have been larger and disparities would have been further alleviated if more states with highly concentrated vulnerable populations had expanded Medicaid.

Suggested Citation

  • Danielle Christine Rhubart, 2017. "Identifying Associations Between State Medicaid Expansion Decisions and Spatial Disparities in County Insurance Rate Changes Under the Affordable Care Act," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 36(1), pages 109-135, February.
  • Handle: RePEc:kap:poprpr:v:36:y:2017:i:1:d:10.1007_s11113-016-9414-0
    DOI: 10.1007/s11113-016-9414-0
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s11113-016-9414-0
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.

    File URL: https://libkey.io/10.1007/s11113-016-9414-0?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. Peter Mieszkowski & Edwin S. Mills, 1993. "The Causes of Metropolitan Suburbanization," Journal of Economic Perspectives, American Economic Association, vol. 7(3), pages 135-147, Summer.
    2. Stallmann, Judith I. & Johnson, Thomas G. & Mwachofi, Ari & Flora, Jan L., 1993. "Labor Market Incentives To Stay In School," Journal of Agricultural and Applied Economics, Southern Agricultural Economics Association, vol. 25(2), pages 1-13, December.
    3. Young, F.W. & Lyson, T.A., 2001. "Structural pluralism and all-cause mortality," American Journal of Public Health, American Public Health Association, vol. 91(1), pages 136-138.
    4. William Kandel & Emilio A. Parrado, 2005. "Restructuring of the US Meat Processing Industry and New Hispanic Migrant Destinations," Population and Development Review, The Population Council, Inc., vol. 31(3), pages 447-471, September.
    5. Stallmann, Judith I. & Johnson, Thomas G. & Mwachofi, Ari & Flora, Jan L., 1993. "Labor Market Incentives to Stay in School," Journal of Agricultural and Applied Economics, Cambridge University Press, vol. 25(2), pages 82-94, December.
    6. Linda Lobao & David S. Kraybill, 2005. "The Emerging Roles of County Governments in Metropolitan and Nonmetropolitan Areas: Findings From a National Survey," Economic Development Quarterly, , vol. 19(3), pages 245-259, August.
    Full references (including those not matched with items on IDEAS)

    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. Claude DIEBOLT & Magali Jaoul-Grammare, 2024. "Gendered Study Choice and Prestige of Professions: France in the Long 20th Century," Working Papers of BETA 2024-37, Bureau d'Economie Théorique et Appliquée, UDS, Strasbourg.
    2. Claude DIEBOLT & Magali JAOUL-GRAMMARE, 2019. "The Cliometric Model of Glutting: An Experimental Analysis," Working Papers of BETA 2019-01, Bureau d'Economie Théorique et Appliquée, UDS, Strasbourg.
    3. Fernando Riosmena & Douglas S. Massey, 2012. "Pathways to El Norte: Origins, Destinations, and Characteristics of Mexican Migrants to the United States," International Migration Review, Wiley Blackwell, vol. 46(1), pages 3-36, March.
    4. David M. Brasington & Diane Hite, 2005. "Demand for Environmental Quality: A Spatial Hedonic Approach," Departmental Working Papers 2005-08, Department of Economics, Louisiana State University.
    5. Youjung Kim & Galen Newman, 2019. "Climate Change Preparedness: Comparing Future Urban Growth and Flood Risk in Amsterdam and Houston," Sustainability, MDPI, vol. 11(4), pages 1-24, February.
    6. Ingrid Gould Ellen & Katherine O'Regan, 2009. "Crime and U.S. Cities: Recent Patterns and Implications," The ANNALS of the American Academy of Political and Social Science, , vol. 626(1), pages 22-38, November.
    7. Kenneth M. Johnson & Daniel T. Lichter, 2016. "Diverging Demography: Hispanic and Non-Hispanic Contributions to U.S. Population Redistribution and Diversity," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 35(5), pages 705-725, October.
    8. Ortuño-Padilla, Armando & Fernández-Aracil, Patricia, 2013. "Impact of fuel price on the development of the urban sprawl in Spain," Journal of Transport Geography, Elsevier, vol. 33(C), pages 180-187.
    9. Georgette C. Poindexter, 1996. "Legal Empowerment of the Neighbourhood," Urban Studies, Urban Studies Journal Limited, vol. 33(10), pages 1821-1829, December.
    10. Monkkonen, Paavo & Zhang, Xiaohu, 2014. "Innovative measurement of spatial segregation: Comparative evidence from Hong Kong and San Francisco," Regional Science and Urban Economics, Elsevier, vol. 47(C), pages 99-111.
    11. Nobles, Jenna & Brown, Ryan & Catalano, Ralph, 2010. "National independence, women's political participation, and life expectancy in Norway," Social Science & Medicine, Elsevier, vol. 70(9), pages 1350-1357, May.
    12. Korwel-Lejkowska Barbara, 2020. "Transformation of the Landscape Structure of the Selected Testing Grounds in the Tri-city Agglomeration in the Years 1985–2012," Quaestiones Geographicae, Sciendo, vol. 39(2), pages 31-42, June.
    13. Zębik Grzegorz, 2011. "Typology of Suburban Communities in Poland," Bulletin of Geography. Socio-economic Series, Sciendo, vol. 16(16), pages 173-188, January.
    14. Edward W. Hill & Harold L. Wolman, 1997. "Accounting for the Change in Income Disparities between US Central Cities and their Suburbs from 1980 to 1990," Urban Studies, Urban Studies Journal Limited, vol. 34(1), pages 43-60, January.
    15. Douglas Gurak & Mary M. Kritz, 2016. "Pioneer settlement of U.S. immigrants," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 34(25), pages 705-740.
    16. Gerald A. Carlino & Satyajit Chatterjee, 1999. "Postwar trends in metropolitan employment growth: decentralization and deconcentration," Working Papers 99-10, Federal Reserve Bank of Philadelphia.
    17. Robert W. Wassmer, 2002. "Fiscalisation of Land Use, Urban Growth Boundaries and Non-central Retail Sprawl in the Western United States," Urban Studies, Urban Studies Journal Limited, vol. 39(8), pages 1307-1327, July.
    18. Paolo Veneri, 2018. "Urban spatial structure in OECD cities: Is urban population decentralising or clustering?," Papers in Regional Science, Wiley Blackwell, vol. 97(4), pages 1355-1374, November.
    19. Huberto M. Ennis & Santiago M. Pinto & Alberto Porto, 2006. "Choosing a place to live and a workplace," Económica, Instituto de Investigaciones Económicas, Facultad de Ciencias Económicas, Universidad Nacional de La Plata, vol. 0(1-2), pages 15-51, January-D.
    20. Edward L. Glaeser & Matthew E. Kahn, 2001. "Decentralized Employment and the Transformation of the American City," Harvard Institute of Economic Research Working Papers 1912, Harvard - Institute of Economic Research.

    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:kap:poprpr:v:36:y:2017:i:1:d:10.1007_s11113-016-9414-0. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.