Public Health Insurance and Medical Spending: The Incidence of the ACA Medicaid Expansion.

This paper examines the incidence of the cost burden associated with expanding public health insurance to low‐income adults in the context of the Affordable Care Act. Using data from the Medical Expenditures Panel Survey (MEPS), I exploit exogenous variation in Medicaid eligibility rules across stat...

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Publicado en:Journal of Policy Analysis & Management Vol. 42; no. 1; pp. 137 - 166
Autor principal: Shupe, Cortnie
Formato: Artículo
Publicado: Wiley-Blackwell Jan2023
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2023
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      pub: Wiley-Blackwell
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        10.1002/pam.22435
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        atl: Public Health Insurance and Medical Spending: The Incidence of the ACA Medicaid Expansion.
      aug:
        au: Shupe, Cortnie
      su:
        Health insurance
        Medical care costs
        Medicaid
        Insurance eligibility
        Health insurance exchanges
        Medicaid eligibility
      sug:
        subj:
          Health insurance
          Medical care costs
          Medicaid
          Direct individual life, health and medical insurance carriers
          Direct group life, health and medical insurance carriers
          Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
          Insurance eligibility
          Health insurance exchanges
          Medicaid eligibility
      ab: This paper examines the incidence of the cost burden associated with expanding public health insurance to low‐income adults in the context of the Affordable Care Act. Using data from the Medical Expenditures Panel Survey (MEPS), I exploit exogenous variation in Medicaid eligibility rules across states, income groups and time. I find that public insurance eligibility reduced mean out‐of‐pocket spending by 19.6 percent among targeted households, but it did not causally increase total expenditures among beneficiaries. Rather, Medicaid expansion shifted the burden of payment from eligible households and private insurance (21.5 percent reduction) to taxpayers in the form of public insurance (46.6 percent increase). The efficiency of these public funds can be summarized by a mean Marginal Value of Public Funds of 0.70 in the full sample, 0.99 among households with at least one pre‐existing condition, and 1.26 in states with an above‐median number of public hospitals.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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