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Medicaid-ing Uninsurance? The Impact of the Affordable Care Act’s Medicaid Expansion on Uninsurance Spells

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Abstract

We study the effect of the Affordable Care Act’s Medicaid expansion on coverage dynamics following the sudden loss of coverage from an employer plan. This analysis leverages novel administrative data capturing monthly health insurance coverage for the U.S. population. Using these data, we develop several stylized facts describing the post-separation coverage dynamics. In addition, we use a difference-in-differences model to estimate the causal effect of Medicaid expansion on the duration of uninsurance following a separation from an employer plan. We find that Medicaid expansion increases the likelihood of finding coverage by 16% and reduces the duration of uninsurance by 12%.

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  • Bradley T. Heim & Elena Patel & Shanthi Ramnath, 2023. "Medicaid-ing Uninsurance? The Impact of the Affordable Care Act’s Medicaid Expansion on Uninsurance Spells," Working Paper Series WP 2023-41, Federal Reserve Bank of Chicago.
    • Handle: RePEc:fip:fedhwp:97421
    DOI: 10.21033/wp-2023-41
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    1. Masanori Kuroki, 2021. "The effect of health insurance coverage on personal bankruptcy: evidence from the Medicaid expansion," Review of Economics of the Household, Springer, vol. 19(2), pages 429-451, June.
    2. Gross, Tal & Notowidigdo, Matthew J., 2011. "Health insurance and the consumer bankruptcy decision: Evidence from expansions of Medicaid," Journal of Public Economics, Elsevier, vol. 95(7-8), pages 767-778, August.
    3. Frean, Molly & Gruber, Jonathan & Sommers, Benjamin D., 2017. "Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act," Journal of Health Economics, Elsevier, vol. 53(C), pages 72-86.
    4. Schaller, Jessamyn & Stevens, Ann Huff, 2015. "Short-run effects of job loss on health conditions, health insurance, and health care utilization," Journal of Health Economics, Elsevier, vol. 43(C), pages 190-203.
    5. Ithai Z. Lurie & James Pearce, 2021. "Health Insurance Coverage in Tax and Survey Data," American Journal of Health Economics, University of Chicago Press, vol. 7(2), pages 164-184.
    6. Cutler, David M. & Gelber, Alexander M., 2009. "Changes in the Incidence and Duration of Periods Without Insurance," Scholarly Articles 5344531, Harvard University Department of Economics.
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    More about this item

    Keywords

    Health insurance; Unemployment; Medicaid expansion;
    All these keywords.

    JEL classification:

    • J65 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Unemployment Insurance; Severance Pay; Plant Closings
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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