Public Health Insurance and Medical Spending: Evidence from the ACA Medicaid Expansion

Arbeitspapier

This paper investigates the short-run impact of public insurance expansion under the Affordable Care Act on out-of-pocket medical spending (OOP) and risk exposure among low-income, eligible households as well as the incidence of the cost of providing insurance. Using data from the Medical Expenditures Panel Survey (MEPS), I exploit exogenous variation in Medicaid eligibility rules across states, income groups and time. I find that public insurance eligibility reduced mean OOP by 18.2% among targeted households, but it did not causally increase total expenditures among beneficiaries. Rather, Medicaid expansion shifted the burden of payment from eligible households and private insurance (17% reduction) to taxpayers in the form of public insurance (45.7% increase). The efficiency of these public funds can be summarized by a Marginal Value of Public Funds ranging from 0.06 to 0.59 that is highest for households with at least one pre-existing condition.

Angaben zum Objekt

• Sprache: Englisch

Verweise und Beziehungen

• Erschienen in: Series: CESifo Working Paper ; No. 8827

Klassifikation und Themen

• Klassifikation: Wirtschaft ; Microeconomic Policy: Formulation, Implementation, and Evaluation ; Allocative Efficiency; Cost-Benefit Analysis ; Publicly Provided Goods: Mixed Markets ; Health Insurance, Public and Private
• Thema: public health insurance ; risk protection ; MVPF ; Medicaid ; out-of-pocket expenditures ; Affordable Care Act

Beteiligte, Orts- und Zeitangaben

• Ereignis: Geistige Schöpfung
• (wer): Shupe, Cortnie
• Ereignis: Veröffentlichung
• (wer): Center for Economic Studies and Ifo Institute (CESifo)
• (wo): Munich
• (wann): 2021

Weitere Informationen

• Handle: http://hdl.handle.net/10419/232424
• Letzte Aktualisierung: 10.03.2025, 11:41 MEZ