Childhood Medicaid Coverage and Later Life Health Care Utilization
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.
This work was supported by the Robert Wood Johnson Foundation’s Health Policy Scholars and Health & Society Scholars Programs at the University of Michigan, Ann Arbor. We would like to thank participants at seminars at the IRP Summer Research Workshop, NBER Summer Institute, UCLA, University of Chicago, and the University of Michigan for excellent comments, as well as Jean Roth, Betty Henderson-Sparks, and Dee Roes for their assistance in accessing the data used in this project. Laura Wherry benefitted from facilities and resources provided by the California Center for Population Research at UCLA (CCPR), which receives core support (R24-HD041022) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.
- Two studies use variation in Medicaid eligibility across birth cohorts and states to estimate the program's long-run...
Laura R. Wherry & Sarah Miller & Robert Kaestner & Bruce D. Meyer, 2018. "Childhood Medicaid Coverage and Later-Life Health Care Utilization," The Review of Economics and Statistics, vol 100(2), pages 287-302. citation courtesy of