Did the Affordable Care Act's Medicaid eligibility expansions crowd out private health insurance coverage
Bibliographic Data
| ID | 11680717 |
|---|---|
| Authors | Conor Lennon (0000-0002-4131-5434, Rensselaer Polytechnic Institute Troy New York USA, corresponding author) |
| Year | 2023 |
| Volume | 44 |
| Issue | 1 |
| Pages | 208-235 |
| Publication date | 2023-12-12 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Journal of Policy Analysis and Management (JOURNAL) |
| Journal identifiers | ISSN: 0276-8739 • E-ISSN: 1520-6688 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1002/pam.22556 |
| OpenAlex | W4389683481 |
| Language | EN |
| Citations received | 1 |
| References cited | 41 |
The Affordable Care Act (ACA) provided funding to help states expand Medicaid eligibility to those earning up to 138% of the Federal Poverty Level. Such expansions in Medicaid eligibility, however, could “crowd out” private insurance coverage, including changes in coverage relating to other ACA provisions. To estimate the extent of such crowd out, I use a difference‐in‐differences empirical approach, examining changes in health insurance coverage sources among low‐income Americans in states that expanded eligibility relative to comparable individuals in states that did not. Using American Community Survey data from 2009 to 2019, I find a 43% crowd‐out rate, consisting of a 10.7 percentage point relative increase in Medicaid coverage among low‐income adults and a 4.6 percentage point relative decline in private health insurance among respondents in states that expanded Medicaid eligibility. Among working adults, my estimates imply a larger 56% rate of crowding out. Event study analyses provide support for a causal interpretation for my findings. I further show that my estimates are robust to different sample restrictions and estimation choices, are not subject to the issues raised by the new difference‐in‐differences literature, and are similar when I use approaches to identifying crowd out common in the existing literature
Actuarial science · American Community Survey · Business · Census · Crowding out · Demographic economics · Economic growth · Economics · Environmental health · Health care · Health insurance · Medicaid · Patient Protection and Affordable Care Act · Percentage point · Point (geometry · Poverty · Private insurance · Public economics · Sample (material · Sociology · Demography · Global Health Care Issues · Healthcare Policy and Management · Medicine · Primary Care and Health Outcomes · Finance
Does Public Insurance Crowd out Private Insurance?
Early Coverage, Access, Utilization, and Health Effects Associated With the Affordable Care Act Medicaid Expansions
Health and Access to Care during the First 2 Years of the ACA Medicaid Expansions
Premium subsidies, the mandate, and Medicaid expansion
Health Insurance Eligibility, Utilization of Medical Care, and Child Health
Two-Way Fixed Effects Estimators with Heterogeneous Treatment Effects
Difference-in-differences with variation in treatment timing
Difference-in-Differences with multiple time periods
Estimating dynamic treatment effects in event studies with heterogeneous treatment effects
Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low-Income Children
Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non‐Expansion States
Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply
Saving Babies
The Effect of Expanding Medicaid Eligibility on the Distribution of Children's Health Insurance Coverage
| Unique citing works | 1 |
|---|---|
| Citations per year | 1 |
| Citation span | 2026 - 2026 (1) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 1 |