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Accessing the Safety Net: How Medicaid Affects Health and Recidivism

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  • Analisa Packham
  • David Slusky

Abstract

We estimate the causal impact of access to means-tested public health insurance coverage (Medicaid) on health outcomes and recidivism for those recently released from incarceration. To do so, we leverage a policy change in South Carolina that allowed simplified Medicaid enrollment for previously incarcerated eligible individuals. Using linked administrative data on criminal convictions and health insurance claims, we find that reducing barriers in access to Medicaid for vulnerable populations increases enrollment and utilization of some health care services. However, we do not find that this improved health care insurance access reduces 1-year or 3-year recidivism, suggesting that effectiveness of such policies is context dependent.

Suggested Citation

  • Analisa Packham & David Slusky, 2023. "Accessing the Safety Net: How Medicaid Affects Health and Recidivism," NBER Working Papers 31971, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:31971
    Note: EH LE
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    1. Jacob Vogler, 2020. "Access to Healthcare and Criminal Behavior: Evidence from the ACA Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(4), pages 1166-1213, September.
    2. Gultekin Gollu & Mariyana Zapryanova, 2022. "The effect of Medicaid on recidivism: Evidence from Medicaid suspension and termination policies," Southern Economic Journal, John Wiley & Sons, vol. 89(2), pages 326-372, October.
    3. Alberto Ortega, 2023. "Medicaid Expansion and mental health treatment: Evidence from the Affordable Care Act," Health Economics, John Wiley & Sons, Ltd., vol. 32(4), pages 755-806, April.
    4. Rosen, D.L. & Dumont, D.M. & Cislo, A.M. & Brockmann, B.W. & Traver, A. & Rich, J.D., 2014. "Medicaid policies and practices in US State Prison Systems," American Journal of Public Health, American Public Health Association, vol. 104(3), pages 418-420.
    5. Wen, Hefei & Hockenberry, Jason M. & Cummings, Janet R., 2017. "The effect of Medicaid expansion on crime reduction: Evidence from HIFA-waiver expansions," Journal of Public Economics, Elsevier, vol. 154(C), pages 67-94.
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    More about this item

    JEL classification:

    • 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
    • K42 - Law and Economics - - Legal Procedure, the Legal System, and Illegal Behavior - - - Illegal Behavior and the Enforcement of Law

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