Antipoverty Impact Of Medicaid Growing With State Expansions Over Time

Health Aff (Millwood). 2019 Jan;38(1):132-138. doi: 10.1377/hlthaff.2018.05155.

Abstract

Out-of-pocket spending on health care pushed over 10.5 million Americans into poverty in 2016. Medicaid helps offset this risk by providing medical coverage to millions of poor and near-poor children and adults and thereby constraining out-of-pocket medical spending. This article examines whether recent state-level expansions to the Medicaid program resulted in reductions in poverty and whether future changes to the program are likely to have similar impacts on poverty. Using a difference-in-differences research design, we found that the recent Medicaid expansion caused a significant reduction in the poverty rate. Moreover, by simulating a counterfactual poverty rate for a hypothetical world without Medicaid coverage, we found that the program's antipoverty impact grew over the past decade independent of expansion, by shielding beneficiaries from growing out-of-pocket spending. Future expansions or retractions of Medicaid are likely to produce associated effects on poverty.

MeSH terms

  • Adult
  • Aged
  • Child
  • Eligibility Determination*
  • Health Expenditures / statistics & numerical data
  • Health Services Accessibility
  • Humans
  • Insurance Coverage*
  • Insurance, Health*
  • Male
  • Medicaid / economics*
  • Medicaid / statistics & numerical data
  • Middle Aged
  • Patient Protection and Affordable Care Act / legislation & jurisprudence
  • Poverty*
  • United States