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The Effect of Expanding Medicaid Eligibility on the Distribution of Children's Health Insurance Coverage

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  • Lara D. Shore-Sheppard

Abstract

Federal legislation passed in the late 1980s greatly expanded the Medicaid program to include children in families with incomes at and above the poverty threshold, regardless of family structure. Using March Current Population Survey data, the author evaluates how the expansions affected private and public insurance coverage levels across the income distribution. Estimates of the extent of take-up of public coverage and substitution of private coverage are used to generate distributions of coverage under two counterfactual situations: absence of expansions, and absence of substitution. The results indicate that the expansions had an equalizing effect on coverage levels across the lower five deciles of the income distribution between 1988 and 1995. In their absence, coverage would have fallen significantly in the third through fifth income deciles. Also, if all of the increased Medicaid enrollment had come from the uninsured population, inequality in coverage levels would have decreased even further.

Suggested Citation

  • Lara D. Shore-Sheppard, 2000. "The Effect of Expanding Medicaid Eligibility on the Distribution of Children's Health Insurance Coverage," ILR Review, Cornell University, ILR School, vol. 54(1), pages 59-77, October.
    • Handle: RePEc:sae:ilrrev:v:54:y:2000:i:1:p:59-77
    DOI: 10.1177/001979390005400104
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    References listed on IDEAS

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    1. Shore-Sheppard, Lara & Buchmueller, Thomas C. & Jensen, Gail A., 2000. "Medicaid and crowding out of private insurance: a re-examination using firm level data," Journal of Health Economics, Elsevier, vol. 19(1), pages 61-91, January.
    2. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 391-430.
    3. Richard N. Rosett, 1976. "The Role of Health Insurance in the Health Services Sector," NBER Books, National Bureau of Economic Research, Inc, number rose76-1.
    4. Blumberg, Linda J. & Dubay, Lisa & Norton, Stephen A., 2000. "Did the Medicaid expansions for children displace private insurance? An analysis using the SIPP," Journal of Health Economics, Elsevier, vol. 19(1), pages 33-60, January.
    5. Helen Levy, 1998. "Who Pays for Health Insurance? Employee Contributions to Health Insurance Premiums," Working Papers 777, Princeton University, Department of Economics, Industrial Relations Section..
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    Cited by:

    1. Yelowitz, Aaron S., 2000. "Public policy and health insurance choices of the elderly: evidence from the medicare buy-in program," Journal of Public Economics, Elsevier, vol. 78(3), pages 301-324, November.
    2. David Card & Lara Dawn Shore-Sheppard, 2001. "Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions," JCPR Working Papers 248, Northwestern University/University of Chicago Joint Center for Poverty Research.
    3. Velamuri, Malathi, 2009. "Taxes, Health Insurance and Women’s Self-Employment," MPRA Paper 15731, University Library of Munich, Germany.
    4. David Card & Lara D. Shore-Sheppard, 2004. "Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low-Income Children," The Review of Economics and Statistics, MIT Press, vol. 86(3), pages 752-766, August.
    5. Stan McMillen & Kathryn Parr & Xiumei Song & Brian Baird, 2004. "The Kerry-Bush Health Care Proposals: A Characterization and Comparison of their Impacts on Connecticut (Technical Appendix)," CCEA Studies 2004-06, University of Connecticut, Connecticut Center for Economic Analysis.
    6. Saavedra, Martin, 2017. "Children's health insurance, family income, and welfare enrollment," Children and Youth Services Review, Elsevier, vol. 73(C), pages 182-186.
    7. A. S. Yelowitz, "undated". "Public Policy and Health Care Choices of the Elderly: Evidence from the Medicare Buy-In Program," Institute for Research on Poverty Discussion Papers 1136-97, University of Wisconsin Institute for Research on Poverty.
    8. John C. Ham & I. Serkan Ozbeklik & Lara Shore-Sheppard, 2010. "Estimating Heterogeneous Treatment Effects of Medicaid Expansions on Take-up and Crowd-out," NBER Working Papers 16112, National Bureau of Economic Research, Inc.

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    More about this item

    JEL classification:

    • E29 - Macroeconomics and Monetary Economics - - Consumption, Saving, Production, Employment, and Investment - - - Other
    • E3 - Macroeconomics and Monetary Economics - - Prices, Business Fluctuations, and Cycles

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