Adult Medicaid Coverage: Effects on Health Care Utilization and Health Outcomes
The Affordable Care Act (ACA) substantially increased insurance coverage among low-income adults. There is great interest among researchers and policy makers on how this coverage expansion will affect access to and the utilization of health care services and health outcomes. The three papers in this session present complementary evidence on this subject. Two papers examine the effects of public insurance in the years just prior to the ACA. Buchmueller and Shore-Sheppard use multiple years of data from the Behavioral Risk Factor Surveillance Survey to estimate the effect of Medicaid eligibility expansions for parents on perceived access to care, the utilization of specific services and several measures of self-reported health. DeLeire, Leininger and Wherry exploit a policy reversal to consider the effect of Medicaid coverage on mortality. The specific context is Wisconsin, where the state first expanded eligibility for public insurance and then froze enrollment, placing individuals who applied after a certain date on a waitlist. The analysis essentially compares mortality rates for individuals who applied for coverage just before enrollment was frozen to those who applied just after. The third paper in the session, by Miller and Wherry, provides early evidence on the effect of the ACA Medicaid expansions on a variety of utilization and health outcomes. The analysis, which is based on restricted data from the National Health Interview Survey, compares adults in states that did and did not implement the Medicaid expansion. Together these studies significantly contribute to our understanding of the effects of public health insurance expansions.