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

Autor/in	Shupe, Cortnie
Titel	Public Health Insurance and Medical Spending: The Incidence of the ACA Medicaid Expansion
Quelle	In: Journal of Policy Analysis and Management, 42 (2023) 1, S.137-165 (29 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0276-8739
DOI	10.1002/pam.22435
Schlagwörter	Health Insurance; Health Care Costs; Federal Legislation; Federal Programs; Social Services; Low Income Groups; Eligibility + Suchen Sie Ihr Suchwort? Krankenversicherung; Bundesrecht; Social service; Soziale Dienstleistung; Soziale Dienste; Eignung
Abstract	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. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2024/1/01