Working Paper: NBER ID: w24899
Authors: Thomas DeLeire
Abstract: This study examines the effect of a Medicaid disenrollment on employment, sources of health insurance coverage, health, and health care utilization of childless adults using longitudinal data from the 2004 Panel of the Survey of Income and Program Participation. From July through September 2005, TennCare, the Tennessee Medicaid program, disenrolled approximately 170,000 adults following a change in eligibility rules. Following this eligibility change, the fraction of adults in Tennessee covered by Medicaid fell by over 5 percentage points while uninsured rates increased by almost 5 percentage points relative to adults in other Southern states. There is no evidence of an increase in employment rates in Tennessee following the disenrollment. Self-reported health and access to medical care worsened as hospitalization rates, doctor visits, and dentist visits all declined while the use of free or public clinics increased. The Tennessee experience suggests that undoing the expansion of Medicaid eligibility to adults that occurred under the Affordable Care Act likely would reduce health insurance coverage, reduce health care access, and worsen health but would not lead to increases in employment.
Keywords: Medicaid; employment; health insurance; health care utilization
JEL Codes: I11; I13; I18; J22
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Medicaid disenrollment (I18) | fraction of adults covered by Medicaid (I18) |
| Medicaid disenrollment (I18) | uninsured rate (I13) |
| Medicaid disenrollment (I18) | private health insurance coverage (I13) |
| Medicaid disenrollment (I18) | employment rates (J68) |
| Medicaid disenrollment (I18) | work-preventing disabilities (J28) |
| Medicaid disenrollment (I18) | shift from full-time to part-time work (J22) |
| Medicaid disenrollment (I18) | self-reported health (I10) |
| Medicaid disenrollment (I18) | access to medical care (I14) |
| Medicaid disenrollment (I18) | hospitalization rates (I18) |
| Medicaid disenrollment (I18) | doctor visits (I11) |
| Medicaid disenrollment (I18) | dentist visits (I11) |
| Medicaid disenrollment (I18) | use of free or public clinics (H40) |