Who did the ACA Medicaid Expansion Impact? Estimating the Probability of Being a Complier [Health Economics] [Publication Link

Abstract: Who enrolled in Medicaid as a consequence of the Affordable Care Act (ACA)? Using the 2010–2017 American Community Survey, I estimate how characteristics relating to work status and race/ethnicity affect the probability that an individual will be a complier, defined as those induced by the ACA Medicaid expansion to obtain Medicaid coverage. Across all states, I find that part-time workers, not non-workers, are the most likely to be compliers. This finding is not consistent with certain notions that Medicaid participants are the "undeserving poor" - a sentiment that may have hindered efforts to expand Medicaid in certain states.  Additionally, I find that in non-expansion states, many of which have high Black populations, the probability of being a complier is higher for Blacks than for other racial/ethnic groups suggesting that Black people in non-expansion would be the largest beneficiaries of any new expansions. This paper not only identifies the types of individuals who were already impacted by the expansion but also identifies which populations would benefit the most from subsequent expansions.

Working Papers

Laying Down the Welcome Mat: The Impact of the ACA Medicaid Expansion on Health Coverage for Previously Eligible Children [Link]

AbstractHow effective was the Affordable Care Act (ACA) in enrolling children already eligible for Medicaid? Utilizing the American Community Survey (ACS)

from 2012 to 2017, I adopt a difference-in-differences approach that measures the changes in public and private coverage for Medicaid and CHIP eligible children before and after the enactment of the ACA Medicaid expansion. I find that there are modest yet significant increases in public coverage for children who were previously eligible for Medicaid and CHIP prior to the expansion, providing evidence of a “welcome mat” effect. However, I see observe significant crowding out in employer-sponsored insurance for both previously eligible children and children who became newly eligible as a result of the new adjusted gross income (MAGI) thresholds established after 2014. My findings not only establish, under the ACA Medicaid expansion, clear evidence of a “welcome mat” effect for children across various age and income groups, but they may also suggest that parents favor fully subsidized public coverage over partially subsidized private insurance for their children.

Works In Progress