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The Effect of the Affordable Care Act Medicaid Expansion on Migration

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  • Lucas Goodman

Abstract

The expansion of Medicaid to low‐income nondisabled adults is a key component of the Affordable Care Act's strategy to increase health insurance coverage, but many states have chosen not to take up the expansion. As a result, for many low‐income adults, there has been stark variation across states in access to Medicaid since the expansions took effect in 2014. This study investigates whether individuals migrate in order to gain access to these benefits. Using an empirical model in the spirit of a difference‐in‐differences, this study finds that migration from non‐expansion states to expansion states did not increase in 2014 relative to migration in the reverse direction. The estimates are sufficiently precise to rule out a migration effect that would meaningfully affect the number of enrollees in expansion states, which suggests that Medicaid expansion decisions do not impose a meaningful fiscal externality on other states.

Suggested Citation

  • Lucas Goodman, 2017. "The Effect of the Affordable Care Act Medicaid Expansion on Migration," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(1), pages 211-238, January.
    • Handle: RePEc:wly:jpamgt:v:36:y:2017:i:1:p:211-238
    DOI: 10.1002/pam.21952
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    Citations

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    Cited by:

    1. Jacqueline Fiore, 2017. "The Impact of the Affordable Care Act's Medicaid Expansion on Medicaid Spending by Health Care Service Category," Working Papers 1706, Tulane University, Department of Economics, revised Mar 2018.
    2. Jun Yeong Lee & John V. Winters, 2022. "State Medicaid Expansion and the Self-Employed," Small Business Economics, Springer, vol. 59(3), pages 925-954, October.
    3. Friederike Seifert, 2022. "The Affordable Care Act Medicaid expansion and interstate migration in border regions of US States [Die Ausweitung von Medicaid durch den Affordable Care Act und zwischenstaatliche Migration in den," Review of Regional Research: Jahrbuch für Regionalwissenschaft, Springer;Gesellschaft für Regionalforschung (GfR), vol. 42(1), pages 49-74, April.
    4. Naoki Aizawa & Chao Fu, 2020. "Interaction of the Labor Market and the Health Insurance System: Employer-Sponsored, Individual, and Public Insurance," NBER Working Papers 26713, National Bureau of Economic Research, Inc.
    5. Lucie Schmidt & Lara D. Shore-Sheppard & Tara Watson, 2020. "The Impact of the ACA Medicaid Expansion on Disability Program Applications," American Journal of Health Economics, University of Chicago Press, vol. 6(4), pages 444-476.
    6. Bryan S. Graham, 2019. "Network Data," NBER Working Papers 26577, National Bureau of Economic Research, Inc.
    7. Isaac, Elliott & Jiang, Haibin, 2022. "Tax-Based Marriage Incentives in the Affordable Care Act," IZA Discussion Papers 15331, Institute of Labor Economics (IZA).
    8. Sarah Miller & Norman Johnson & Laura R Wherry, 2021. "Medicaid and Mortality: New Evidence From Linked Survey and Administrative Data," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 136(3), pages 1783-1829.
    9. Jorge González-Chapela & Raquel Ortega-Lapiedra, 2021. "Reform of the Personal Income Tax in Spain: Effects on Internal Mobility of the Unemployed," Journal of Family and Economic Issues, Springer, vol. 42(1), pages 166-181, March.
    10. Jonathan Gruber & Benjamin D. Sommers, 2020. "Fiscal Federalism and the Budget Impacts of the Affordable Care Act's Medicaid Expansion," NBER Working Papers 26862, National Bureau of Economic Research, Inc.
    11. Maclean Johanna Catherine & Cook Benjamin & Carson Nicholas & Pesko Michael F, 2019. "Public Health Insurance and Prescription Medications for Mental Illness," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 19(1), pages 1-25, January.
    12. Julia Shu-Huah Wang, 2021. "State TANF Time Limit and Work Sanction Stringencies and Long-Term Trajectories of Welfare Use, Labor Supply, and Income," Journal of Family and Economic Issues, Springer, vol. 42(4), pages 650-696, December.
    13. Chad Cotti & Erik Nesson & Nathan Tefft, 2019. "Impacts of the ACA Medicaid expansion on health behaviors: Evidence from household panel data," Health Economics, John Wiley & Sons, Ltd., vol. 28(2), pages 219-244, February.
    14. Qiwei He & Scott Barkowski, 2020. "The effect of health insurance on crime: Evidence from the Affordable Care Act Medicaid expansion," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 261-277, March.
    15. Riley Wilson, 2021. "Isolated States of America: The Impact of State Borders on Mobility and Regional Labor Market Adjustments," Upjohn Working Papers 21-358, W.E. Upjohn Institute for Employment Research.
    16. Lucie Schmidt & Lara Shore-Sheppard & Tara Watson, 2019. "The Impact of Expanding Public Health Insurance on Safety Net Program Participation: Evidence from the ACA Medicaid Expansion," NBER Working Papers 26504, National Bureau of Economic Research, Inc.
    17. Shi, Xuezhu, 2020. "Locked out? China’s health insurance scheme and internal migration," Labour Economics, Elsevier, vol. 67(C).
    18. Joanna Woronkowicz & Aparna Soni & Seth Freedman & Kosali Simon, 2020. "How have recent health insurance expansions affected coverage among artist occupations in the USA?," Journal of Cultural Economics, Springer;The Association for Cultural Economics International, vol. 44(1), pages 117-154, March.

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