Working Paper: NBER ID: w17190
Authors: Amy Finkelstein; Sarah Taubman; Bill Wright; Mira Bernstein; Jonathan Gruber; Joseph P. Newhouse; Heidi Allen; Katherine Baicker; The Oregon Health Study Group
Abstract: In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides a unique opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group.
Keywords: Medicaid; Health Insurance; Randomized Controlled Trial; Health Outcomes; Financial Strain
JEL Codes: H51; H75; I1
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Health Insurance Coverage (I13) | Health Care Utilization (I11) |
| Health Care Utilization (I11) | Hospital Admissions (I19) |
| Health Care Utilization (I11) | Prescription Drug Use (I11) |
| Health Care Utilization (I11) | Outpatient Visits (I11) |
| Health Insurance Coverage (I13) | Out-of-Pocket Medical Expenses (H51) |
| Health Insurance Coverage (I13) | Medical Debt (H63) |
| Health Insurance Coverage (I13) | Self-Reported Health (I10) |
| Health Insurance Coverage (I13) | Mental Health (I19) |
| Medicaid lottery selection (I18) | Health Insurance Coverage (I13) |