Working Paper: NBER ID: w20929
Authors: Laura R. Wherry; Sarah Miller; Robert Kaestner; Bruce D. Meyer
Abstract: Policy-makers have argued that providing public health insurance coverage to the uninsured lowers long-run costs by reducing the need for expensive hospitalizations and emergency department visits later in life. In this paper, we provide evidence for such a phenomenon by exploiting a legislated discontinuity in the cumulative number of years a child is eligible for Medicaid based on date of birth. We find that having more years of Medicaid eligibility in childhood is associated with fewer hospitalizations and emergency department visits in adulthood for blacks. Our effects are particularly pronounced for hospitalizations and emergency department visits related to chronic illnesses and those of patients living in low-income neighborhoods. Furthermore, we find evidence suggesting that these effects are larger in states where the difference in the number of Medicaid-eligible years across the cutoff birthdate is greater. Calculations suggest that lower rates of hospitalizations and emergency department visits during one year in adulthood offset between 3 and 5 percent of the initial costs of expanding Medicaid.
Keywords: No keywords provided
JEL Codes: I12; I13; I28
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Increased Medicaid eligibility in childhood (I18) | Variability in effects by race and socioeconomic status (I14) |
| Increased Medicaid eligibility in childhood (I18) | More significant effects in states with greater difference in Medicaid-eligible years across the cutoff (I18) |
| Increased Medicaid eligibility in childhood (I18) | Reduction in hospitalizations in adulthood (I14) |
| Increased Medicaid eligibility in childhood (I18) | Reduction in emergency department visits in adulthood (I12) |
| Reduction in hospitalizations in adulthood (I14) | Lower long-term costs (J32) |
| Increased Medicaid eligibility in childhood (I18) | Reduction in hospitalizations related to chronic illnesses in adulthood (I12) |