The Long-Run Effects of Childhood Insurance Coverage: Medicaid Implementation, Adult Health, and Labor Market Outcomes

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Abstract

This paper estimates the long-run effects of childhood Medicaid eligibility on adult health and economic outcomes using the program’s original introduction ( 1966–1970) and its mandated coverage of welfare recipients. The design compares cohorts born in different years relative to Medicaid implementation, in states with different preexisting welfare-based eligibility. Early childhood Medicaid eligibility reduces mortality and disability, increases employment, and reduces receipt of disability transfer programs up to 50 years later. Medicaid has saved the government more than its original cost and saved more than 10 million quality adjusted life years. (JEL H51, I12, I18, I32, I38, J13)

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Mostly Harmless Econometrics

Joshua Angrist, Jörn-Steffen Pischke (2009)

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Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century.

Anne Case, Angus Deaton (2015)

This paper documents a marked increase in the all-cause mortality of middle-aged white non-Hispanic men and women in the United States between 1999 and 2013. This change reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround. The midlife mortality reversal was confined to white non-Hispanics; black non-Hispanics and Hispanics at midlife, and those aged 65 and above in every racial and ethnic group, continued to see mortality rates fall. This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. Although all education groups saw increases in mortality from suicide and poisonings, and an overall increase in external cause mortality, those with less education saw the most marked increases. Rising midlife mortality rates of white non-Hispanics were paralleled by increases in midlife morbidity. Self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work, as well as clinically measured deteriorations in liver function, all point to growing distress in this population. We comment on potential economic causes and consequences of this deterioration.

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The Oregon Health Insurance Experiment: Evidence from the First Year

Sarah A. Finkelstein, S Taubman, O. B. Wright … (2012)

In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group.

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Author and article information

Journal

Title: American Economic Review

Abbreviated Title: American Economic Review

Publisher: American Economic Association

ISSN (Print): 0002-8282

Publication date Created: August 01 2021

Publication date (Print): August 01 2021

Volume: 111

Issue: 8

Pages: 2550-2593

Affiliations

[1 ]Opportunity and Inclusive Growth Institute, Federal Reserve Bank of Minneapolis (email: )

Article

DOI: 10.1257/aer.20171671

SO-VID: ebe1e7de-bc60-4b33-8e1e-5608e42dcc1e

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