The Affordable Care Act expanded Medicaid eligibility to adults who are below 138 percent of the federal poverty level. There is little to no evidence on the employment effects of the Medicaid expansion in 2014. This paper investigates the pre/post labor market implications of Medicaid expansion with a population near the eligibility cutoff. Using an exogenous variation at the eligibility cutoff, I find a large reduction in part-time employment (<35 Hrs) relative to full-time employment (≥35 Hrs). The reduction in part-time employment (<35 Hrs) suggests that most of the individuals drop out of the labor force, although some transition into full-time employment (≥35 Hrs) or unemployment. The employment transitions imply that labor supply is flexible after being eligible for Medicaid. The labor supply flexibility is also observed for females, middle-aged adults (49-64 years of age), never-married adults and high-school dropouts. When difference-in-differences (DD) model is used for the whole population, the estimates are similar to those in the literature that find no employment effects. The DD model, however, fails to incorporate eligibility measures and also includes adults who are less likely to have Medicaid.
While headlines fixate on the future of the Affordable Care Act’s health insurance exchanges, a more consequential fight is brewing over the future of Medicaid. Proposed reforms would affect tens of millions of Americans and state governments across the country. Previous attempts have failed, however, and longstanding roadblocks may sink this administration’s efforts as well.
Allocating money based on current spending would lock in large and arguably unfair variation in funding across states. Current federal spending per low-income resident varies by a factor of 11 to 1 across the country. Permanently entrenching this variation would justifiably draw the ire of states locked permanently into low federal contributions.Alternatively, block grants could be allocated using ne
Medicaid is a program in great need of reducing costs and improving outcomes for its beneficiaries. Medicaid managed care programs can assist in accomplishing both of these goals. Medical homes, developed in conjunction with managed care programs, can provide even greater benefit, particularly for those patients with the greatest needs, such as children, the aged and the disabled. Medical homes provide for enhanced coordination of care, with particular consideration given to each patient’s (and their families’) desires and limitations. Medicaid managed care programs working in conjunction with medical homes could provide significant benefits to patients, as well as federal and state budgets. Quality metrics and evidence-based standards of care designed specifically for children and patients with chronic needs should be developed.
A recent analysis by The Heritage Foundation’s Edmund Haislmaier and Drew Gonshorowski uses the more accurate method, taking actual enrollment data from Medicaid and private insurance companies to assess the impact Obamacare has had on coverage.
The researchers found that just over 14 million people gained coverage from the end of 2013 to the end of 2015. Of those 14 million, 11.8 million gained their insurance through Medicaid and 2.2 million through private coverage.
Our simulations show that a primary driver of long-term fiscal challenges for the state and local government sector continues to be the growth in health-related costs. Specifically, state and local Medicaid expenditures and the cost of health care compensation for state and local government employees and retirees generally grow at a rate that exceeds GDP.7 The model’s simulations suggest that the sector’s health-related costs will be about 4.1 percent of GDP in 2016 and 6.3 percent of GDP in 2065. From 2016 through 2065, Medicaid expenditures are expected to increase on average by 0.5 percentage points more than GDP—referred to as excess cost growth. Other health related receipts and expenditures, including health care compensation for state and local government employees and retirees, are expected to increase on average by 0.9 percentage points more than GDP each year from 2016 to 2023, and then begin to decline, reaching 0.7 percentage points in 2065.
The Long-Run Effects of Childhood Insurance Coverage: Medicaid Implementation, Adult Health, and Labor Market OutcomesDecember 5, 2016
This paper exploits the original introduction of Medicaid (1966-1970) and the federal mandate that states cover all cash welfare recipients to estimate the effect of childhood Medicaid eligibility on adult health, labor supply, program participation, and income. Cohorts born closer to Medicaid implementation and in states with higher pre-existing welfare-based eligibility accumulated more Medicaid eligibility in childhood but did not differ on a range of other health, socioeconomic, and policy characteristics. Early childhood Medicaid eligibility reduces mortality and disability and, for whites, increases extensive margin labor supply, and reduces receipt of disability transfer programs and public health insurance up to 50 years later. Total income does not change because earnings replace disability benefits. The government earns a discounted annual return of between 2 and 7 percent on the original cost of childhood coverage for these cohorts, most of which comes from lower cash transfer payments.