The Affordable Care Act (ACA) expanded Medicaid coverage to approximately 11 million working-age adults. Critics have raised concerns about providing Medicaid to adults capable of working. Several states have proposed work requirements in Section 1115 Medicaid waivers.1,2 Although none were approved during the Obama administration, the Trump administration is willing to consider such provisions.3 Prior analyses4 estimated that half of adults eligible for ACA Medicaid expansion were employed, and 62% of nondisabled adults were working or in school. Although these national estimates of Medicaid-eligible individuals are valuable, less is known about the employment experience of actual enrollees in Medicaid expansion states and which health characteristics may keep them from working. Complementary state-level analyses are needed as individual states consider whether to propose work requirements. This study examined the demographic and health characteristics associated with the employment status of current Medicaid expansion enrollees in Michigan, which expanded Medicaid under a Section 1115 waiver to nonelderly adults with incomes at or below 133% of the federal poverty level who do not otherwise qualify for Medicaid or Medicare based on disability or other criteria.
Almost all recent literature on Medicaid and labor supply has used Affordable Care Act (ACA)- induced Medicaid eligibility expansions in various states as natural experiments. Estimated effects on employment and earnings differ widely due to differences in the scope of eligibility expansion across states. Using a Regression Kink Design (RKD) framework, this paper takes a uniquely different approach to the identification of the effect of Medicaid generosity on household income. Both state-level data and March CPS data from 1980–2013 suggest that generous federal funding of state-level Medicaid costs have a modest negative effect on household income. The negative impact of Medicaid generosity on household income is more pronounced at the lower end of the household income distribution and on the income and earnings of female heads.
It’s never too early to start thinking about the upcoming 2018 elections. And while a lot of the focus so far has been on the House, a handful of hotly contested gubernatorial races could have higher stakes for health care — specifically, for the Affordable Care Act’s Medicaid expansion.
A raft of open governors’ races next year will give Democrats a chance to replace some of the most stridently anti-expansion governors in the country — and, if they win even a few of those races, the chance to cover millions of currently uninsured people even as the Trump administration drags its heels on so much of the ACA.
Although plans to repeal the ACA and restructure Medicaid financing are struggling to gain ground in the Senate, it remains likely that states across the country will see changes to their Medicaid programs in the years to come. State policymakers will continue to propose plans for reining in spending and tightening eligibility, such as premiums and work requirements, and these types of reforms are likely to win federal approval under the Trump Administration.This webinar will offer a primer for understanding potential changes to Medicaid as well as story ideas for reporters across the country.
Impact of Children’s Health Insurance Bene fit on Labor Supply: Evidence from Newly Arrived Immigrants in the United States by Keshar M. Ghimire :: SSRNJune 24, 2017
This paper exploits the State Children’s Health Insurance Program of the United States to investigate impact of a publicly funded health insurance benefit for children on work behavior of adult men and women. Drawing data from the Annual Social and Economic Supplement of the Current Population Survey and employing a triple- difference identification strategy, I find that public health insurance benefit for children decreases labor supply of women but increases that of men. Estimates suggest that, on average, labor force participation rate of women decreased by 7.4 percentage points while that of men increased by 5.5 percentage points as their families became eligible for State Children’s Health Insurance Program. The findings are supported by a number of robustness checks and a falsification exercise.
The Impact of Recent Mental Health Changes on Employment: New Evidence from Longitudinal Data by Sophie Mitra, Kristine Jones :: SSRNJune 24, 2017
This study uses longitudinal data and four different measures of mental health to tease out the impact of psychiatric disorder onsets and recoveries on employment outcomes. Results suggest that developing a mental health problem leads to a significant increase in the probability of transitioning to non-employment, while a recovery increases the probability of return to work among the not employed with a mental health problem. No consistent effect was found on hours worked and earnings. Research and policy attention is needed with respect to early interventions such as job retention programmes to help workers with mental health problems remain employed as well as interventions that may lead to recovery and return to work. More research is needed especially with data and models that can differentiate between the effects of mental health onsets and recoveries on employment exit and return to work transitions.
As discussed above, states cannot combine savings under Section 1115 and Section 1332 waivers into a single budget-deficit neutrality test. This clarification, along with the further definition of the guardrails, has been characterized by some as limiting states’ flexibility under the statute. As such, it is not clear how many states will pursue Section 1332 waivers and whether any of the reforms will lead to changes in Medicaid or CHIP. Furthermore, given the timing of their implementation (January 2017), the change in
administration at the federal level may alter the parameters in which states can seek these waivers.