Welcome Mats and On‐Ramps for Older Adults: The Impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid.

For many low‐income Medicare beneficiaries, Medicaid provides important supplemental insurance that covers out‐of‐pocket costs and additional benefits. We examine whether Medicaid participation by low‐income adults age 65 and up increased as a result of Medicaid expansions to working‐age adults unde...

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Publicado en:Journal of Policy Analysis & Management Vol. 40; no. 1; pp. 12 - 42
Autores principales: McInerney, Melissa, Mellor, Jennifer M., Sabik, Lindsay M.
Formato: Artículo
Publicado: Wiley-Blackwell Dec2021
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2021
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      pub: Wiley-Blackwell
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        10.1002/pam.22259
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        atl: Welcome Mats and On‐Ramps for Older Adults: The Impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid.
      aug:
        au:
          McInerney, Melissa
          Mellor, Jennifer M.
          Sabik, Lindsay M.
      su:
        Older people
        American Community Survey
        Medicaid
        Medicare
        Patient Protection & Affordable Care Act
        Health insurance exchanges
        Internet content management systems
      sug:
        subj:
          Older people
          American Community Survey
          Medicaid
          Medicare
          Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
          Patient Protection & Affordable Care Act
          Health insurance exchanges
          Internet content management systems
      ab: For many low‐income Medicare beneficiaries, Medicaid provides important supplemental insurance that covers out‐of‐pocket costs and additional benefits. We examine whether Medicaid participation by low‐income adults age 65 and up increased as a result of Medicaid expansions to working‐age adults under the Affordable Care Act (ACA). Previous literature documents so‐called "welcome mat" effects in other populations but has not explicitly studied older persons dually eligible for Medicare and Medicaid. We extend this literature by estimating models of Medicaid participation among persons age 65 and up using American Community Survey data from 2010 to 2017 and state variation in ACA Medicaid expansions. We find that Medicaid expansions to working‐age adults increased Medicaid participation among low‐income older adults by 1.8 percentage points (4.4 percent). We also find evidence of an "on‐ramp" effect; that is, low‐income Medicare beneficiaries residing in expansion states who were young enough to gain coverage under the 2014 ACA Medicaid expansions before aging into Medicare were 4 percentage points (9.5 percent) more likely to have dual Medicaid coverage relative to similar individuals who either turned 65 before the 2014 expansions or resided in non‐expansion states. This on‐ramp effect is an important mechanism behind welcome mat effects among some older adults.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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