Working Paper: NBER ID: w12536
Authors: Jeffrey R. Brown; Norma B. Coe; Amy Finkelstein
Abstract: This paper provides empirical evidence of Medicaid crowd out of demand for private long-term care insurance. Using data on the near- and young-elderly in the Health and Retirement Survey, our central estimate suggests that a $10,000 decrease in the level of assets an individual can keep while qualifying for Medicaid would increase private long-term care insurance coverage by 1.1 percentage points. These estimates imply that if every state in the country moved from their current Medicaid asset eligibility requirements to the most stringent Medicaid eligibility requirements allowed by federal law â€" a change that would decrease average household assets protected by Medicaid by about $25,000 â€" demand for private long-term care insurance would rise by 2.7 percentage points. While this represents a 30 percent increase in insurance coverage relative to the baseline ownership rate of 9.1 percent, it also indicates that the vast majority of households would still find it unattractive to purchase private insurance. We discuss reasons why, even with extremely stringent eligibility requirements, Medicaid may still exert a large crowd-out effect on demand for private insurance.
Keywords: Medicaid; Long-Term Care Insurance; Health and Retirement Survey
JEL Codes: G22; H51; H53; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Medicaid asset protection (G52) | demand for private long-term care insurance (G52) |
| increase in protected assets (G19) | demand for private long-term care insurance (G52) |
| decrease in average protected assets (G19) | demand for private long-term care insurance (G52) |
| Medicaid asset protection (G52) | likelihood of holding long-term care insurance (G52) |