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Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low-Income Children

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  • David Card

    (University of California at Berkeley)

  • Lara D. Shore-Sheppard

    (Williams College)

Abstract

Despite intensive scrutiny, the effects of Medicaid expansions on the health insurance status of low-income children remain controversial. We reexamine the effects of the two largest federally mandated expansions which offered Medicaid coverage to low-income children in specific age ranges and birth cohorts. We use a regression discontinuity approach, comparing Medicaid enrollment, private insurance coverage, and overall insurance coverage on either side of the age limits of the laws. We conclude that the modest impacts of the expansions on health insurance coverage arose because of very low takeup rates of the newly available coverage, rather than from crowdout of private insurance coverage. © 2004 President and Fellows of Harvard College and the Massachusetts Institute of Technology.

Suggested Citation

  • 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.
    • Handle: RePEc:tpr:restat:v:86:y:2004:i:3:p:752-766
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    References listed on IDEAS

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    1. Pischke, Jorn-Steffen, 1995. "Individual Income, Incomplete Information, and Aggregate Consumption," Econometrica, Econometric Society, vol. 63(4), pages 805-840, July.
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    3. Angrist, Joshua D. & Krueger, Alan B., 1999. "Empirical strategies in labor economics," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 23, pages 1277-1366, Elsevier.
    4. 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.
    5. John Ham & Lara Dawn Shore-Sheppard, 2000. "The Effect of Medicaid Expansions for Low-Income Children on Medicaid Participation and Insurance Coverage: Evidence from the SIPP," JCPR Working Papers 164, Northwestern University/University of Chicago Joint Center for Poverty Research.
    6. 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.
    7. Esel Y. Yazici & Robert Kaestner, 1998. "Medicaid Expansions and The Crowding Out of Private Health Insurance," NBER Working Papers 6527, National Bureau of Economic Research, Inc.
    8. 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.
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    More about this item

    JEL classification:

    • I30 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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