The poverty-reducing effect of Medicaid

被引:93
作者
Sommers, Benjamin D. [1 ]
Oellerich, Donald [2 ]
机构
[1] Harvard Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02115 USA
[2] US Dept Hlth & Human Serv, Off Assistant Secretary Planning & Evaluat, Washington, DC 20201 USA
关键词
Medicaid; Health insurance; Poverty; Medical costs; HEALTH-INSURANCE; PUBLIC INSURANCE; PRIVATE INSURANCE; CARE; EXPANSIONS; COVERAGE; PARTICIPATION; CHILDREN; CROWD; ELIGIBILITY;
D O I
10.1016/j.jhealeco.2013.06.005
中图分类号
F [经济];
学科分类号
02 ;
摘要
Medicaid provides health insurance for 54 million Americans. Using the Census Bureau's Supplemental Poverty Measure (which subtracts out-of-pocket medical expenses from family resources), we estimated the impact of eliminating Medicaid. In our counterfactual, Medicaid beneficiaries would become uninsured or gain other insurance. Counterfactual medical expenditures were drawn stochastically from propensity-score-matched individuals without Medicaid. While this method captures the importance of risk protection, it likely underestimates Medicaid's impact due to unobserved differences between Medicaid and non-Medicaid individuals. Nonetheless, we find that Medicaid reduces out-of-pocket medical spending from $871 to $376 per beneficiary, and decreases poverty rates by 1.0% among children, 2.2% among disabled adults, and 0.7% among elderly individuals. When factoring in institutionalized populations, an additional 500,000 people were kept out of poverty. Overall, Medicaid kept at least 2.6 million-and as many as 3.4 million-out of poverty in 2010, making it the U.S.'s third largest anti-poverty program. Published by Elsevier B.V.
引用
收藏
页码:816 / 832
页数:17
相关论文
共 54 条
[41]  
Sommers B. D., 2012, NEW ENGLAND J MED
[42]   Reasons For The Wide Variation In Medicaid Participation Rates Among States Hold Lessons For Coverage Expansion In 2014 [J].
Sommers, Benjamin D. ;
Tomasi, Meredith Roberts ;
Swartz, Katherine ;
Epstein, Arnold M. .
HEALTH AFFAIRS, 2012, 31 (05) :909-919
[43]   Who really pays for health insurance? The incidence of employer-provided health insurance with sticky nominal wages [J].
Sommers B.D. .
International Journal of Health Care Finance and Economics, 2005, 5 (1) :89-118
[44]   Loss of Health Insurance Among Non-elderly Adults in Medicaid [J].
Sommers, Benjamin D. .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2009, 24 (01) :1-7
[45]  
SUMMERS LH, 1989, AM ECON REV, V79, P177
[47]  
Thorpe KE, 1998, INQUIRY-J HEALTH CAR, V35, P369
[48]  
Truffer C.J., 2012, 2011 Actuarial Report on the Financial Status of Medicaid
[49]  
Ujvaru K., 2012, LONG TERM CARE INSUR
[50]   Social security and the retirement and savings behavior of low-income households [J].
van der Klaauw, Wilbert ;
Wolpin, Kenneth I. .
JOURNAL OF ECONOMETRICS, 2008, 145 (1-2) :21-42