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Childhood Medicaid Coverage and Later-Life Health Care Utilization

Author

Listed:
  • Laura R. Wherry

    (David Geffen School of Medicine, University of California, Los Angeles)

  • Sarah Miller

    (Ross School of Business, University of Michigan and NBER)

  • Robert Kaestner

    (University of Illinois and NBER)

  • Bruce D. Meyer

    (University of Chicago and NBER)

Abstract

Exploiting a discontinuity in childhood Medicaid eligibility based on date of birth, we find that more years of childhood eligibility are associated with fewer hospitalizations in adulthood. For blacks, we find a 7% to 15% decrease in hospitalizations and a suggestive 2% to 5% decrease in emergency department visits, but no similar effect for nonblacks. The effects are pronounced for utilization related to chronic illnesses and for patients living in low-income postal codes. Calculations suggest that lower rates of hospitalizations during one year in adulthood for blacks offset between 2% and 4% of the initial costs of expanding Medicaid for all children.

Suggested Citation

  • Laura R. Wherry & Sarah Miller & Robert Kaestner & Bruce D. Meyer, 2018. "Childhood Medicaid Coverage and Later-Life Health Care Utilization," The Review of Economics and Statistics, MIT Press, vol. 100(2), pages 287-302, May.
    • Handle: RePEc:tpr:restat:v:100:y:2018:i:2:p:287-302
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    References listed on IDEAS

    as
    1. Laura R. Wherry & Bruce D. Meyer, 2016. "Saving Teens: Using a Policy Discontinuity to Estimate the Effects of Medicaid Eligibility," Journal of Human Resources, University of Wisconsin Press, vol. 51(3), pages 556-588.
    2. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 431-466.
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    4. Sarah R. Cohodes & Daniel S. Grossman & Samuel A. Kleiner & Michael F. Lovenheim, 2016. "The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions," Journal of Human Resources, University of Wisconsin Press, vol. 51(3), pages 727-759.
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    6. 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.
    7. Sebastian Calonico & Matias D. Cattaneo & Rocio Titiunik, 2014. "Robust Nonparametric Confidence Intervals for Regression‐Discontinuity Designs," Econometrica, Econometric Society, vol. 82, pages 2295-2326, November.
    8. Anne Case & Darren Lubotsky & Christina Paxson, 2002. "Economic Status and Health in Childhood: The Origins of the Gradient," American Economic Review, American Economic Association, vol. 92(5), pages 1308-1334, December.
    9. James Marton & Aaron Yelowitz, 2015. "Health insurance generosity and conditional coverage: Evidence from medicaid managed care in Kentucky," Southern Economic Journal, John Wiley & Sons, vol. 82(2), pages 535-555, October.
    10. Howell, E. & Decker, S. & Hogan, S. & Yemane, A. & Foster, J., 2010. "Declining child mortality and continuing racial disparities in the era of the Medicaid and SCHIP insurance coverage expansions," American Journal of Public Health, American Public Health Association, vol. 100(12), pages 2500-2506.
    11. Dafny, Leemore & Gruber, Jonathan, 2005. "Public insurance and child hospitalizations: access and efficiency effects," Journal of Public Economics, Elsevier, vol. 89(1), pages 109-129, January.
    12. David W. Brown & Amanda E. Kowalski & Ithai Z. Lurie, 2015. "Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?," NBER Working Papers 20835, National Bureau of Economic Research, Inc.
    13. Sarah Miller & Laura R. Wherry, 2019. "The Long-Term Effects of Early Life Medicaid Coverage," Journal of Human Resources, University of Wisconsin Press, vol. 54(3), pages 785-824.
    14. Currie, Janet & Decker, Sandra & Lin, Wanchuan, 2008. "Has public health insurance for older children reduced disparities in access to care and health outcomes?," Journal of Health Economics, Elsevier, vol. 27(6), pages 1567-1581, December.
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    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I28 - Health, Education, and Welfare - - Education - - - Government Policy

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