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The Impact of Medicaid on Medical Utilization in a Vulnerable Population: Evidence from COFA Migrants

Author

Listed:
  • Halliday, Timothy J.

    (University of Hawaii at Manoa)

  • Akee, Randall K. Q.

    (University of California, Los Angeles)

  • Sentell, Tetine

    (University of Hawaii at Manoa)

  • Inada, Megan

    (Kokua Kalihi Valley Comprehensive Family Services)

  • Miyamura, Jill

    (Hawaii Health Information Corporation)

Abstract

In March 2015, the State of Hawaii stopped covering the majority of migrants from countries belonging to the Compact of Free Association (COFA) in its Medicaid program. COFA migrants were required to obtain private insurance in the exchanges established under the Affordable Care Act. Using statewide hospital discharge data, we show that Medicaid-funded hospitalizations and emergency room visits declined in this population by 31% and 19%. Utilization funded by private insurance did increase, but not enough to offset the declines in Medicaid-funded utilization. Finally, the expiration of benefits increased uninsured ER visits.

Suggested Citation

  • Halliday, Timothy J. & Akee, Randall K. Q. & Sentell, Tetine & Inada, Megan & Miyamura, Jill, 2019. "The Impact of Medicaid on Medical Utilization in a Vulnerable Population: Evidence from COFA Migrants," IZA Discussion Papers 12779, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp12779
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    References listed on IDEAS

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    1. Timothy J. Halliday & Randall Q. Akee, 2020. "The impact of Medicaid on medical utilization in a vulnerable population: Evidence from COFA migrants," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1231-1250, October.
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    13. Michael R.M. Abrigo & Timothy J. Halliday & Teresa Molina, 2022. "Expanding health insurance for the elderly of the Philippines," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 37(3), pages 500-520, April.
    14. 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.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 12th October 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-10-12 11:00:03

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    Cited by:

    1. Jonathan Gruber & Benjamin D. Sommers, 2019. "The Affordable Care Act’s Effects on Patients, Providers and the Economy: What We’ve Learned So Far," NBER Working Papers 25932, National Bureau of Economic Research, Inc.
    2. Daniel Sebastian Tello‐Trillo, 2021. "Effects of losing public health insurance on preventative care, health, and emergency department use: Evidence from the TennCare disenrollment," Southern Economic Journal, John Wiley & Sons, vol. 88(1), pages 322-366, July.
    3. Timothy J. Halliday & Randall Q. Akee, 2020. "The impact of Medicaid on medical utilization in a vulnerable population: Evidence from COFA migrants," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1231-1250, October.

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    More about this item

    Keywords

    immigration; health insurance; cost sharing; Medicaid; insurance exchange;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers

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