Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?

Brown, David W.; Kowalski, Amanda; Lurie, Ithai Z.

doi:10.2139/ssrn.2548603

Cited by 40 publications

(64 citation statements)

References 33 publications

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“…In this paper, I corroborate findings from other recent work finding substantial and positive impacts on educational attainment and labor market outcomes stemming from the child Medicaid expansions of the late 1980s and early 1990s (Brown, Kowalski, and Lurie 2015;Cohodes et al 2016;Miller and Wherry 2018). In particular, this work complements and extends the literature by (1) combining both the expansions of Medicaid to children and their pregnant mothers, (2) by more precisely targeting the source of the completion rate gains (Hispanic and Whites), and (3) by corroborating gains in human capital by utilizing two underexplored sources of data-one of which reveals meaningful gains in human capital via increases in traditional high school diplomas.…”

Section: Discussionsupporting

confidence: 88%

“…Three other recent papers have investigated topics central to this research. In their working paper, Brown, Kowalski, and Lurie (2015) use Internal Revenue Service data to find a positive impact of child Medicaid expansions on longerterm labor force earnings. They also report that public health insurance expansions increased the probability of enrollment in college.…”

Section: Theoretical Framework and Literature Reviewmentioning

confidence: 99%

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Still “Saving Babies”? The Impact of Child Medicaid Expansions on High School Completion Rates

Groves

2019

Contemporary Economic Policy

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The decoupling of child Medicaid from the cash welfare system greatly increased access to public health insurance for low‐income children in the United States. In this paper, I show that the federally mandated public health insurance expansions of the late‐1980s and early‐1990s significantly increased the number of public high school completers in the 2000s. Using the legislated generosity of a state's child Medicaid program as a time‐varying, exogenous source of variation in a quasi‐experimental design, I find substantively large declines in the dropout rate and, importantly, large increases in traditional 4‐year graduation rates. Results for both measures are driven by Hispanic and White students, the two groups experiencing the greatest within‐group increases in eligibility due to the decoupling of child Medicaid from the Aid to Families with Dependent Children program. In addition, I find evidence that increases in the length of childhood years covered (e.g., through age 5 vs. through age 17) leads to greater gains in completion rates. This suggests that public health insurance coverage throughout childhood produces the largest effect. (JEL C23, H51, H52, H75, I21)

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Section: Discussionsupporting

confidence: 88%

Section: Theoretical Framework and Literature Reviewmentioning

confidence: 99%

Still “Saving Babies”? The Impact of Child Medicaid Expansions on High School Completion Rates

Groves

2019

Contemporary Economic Policy

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“…Third, different from our study Brown, Kowalski and Lurie (2015) and Cohodes et al (2016) provide evidence that expansions of public insurance programs increase the educational attainment and the earnings of individuals benefiting from these expansions when they were children. Access to health insurance is linked to better child health as well as improved family finances that allow for better schooling access as well as higher graduation rates from high schools and colleges.…”

Section: Introductioncontrasting

confidence: 88%

“…Improvements in health status due to the mandate can increase the college enrollment rate for some marginal students. Brown, Kowalski and Lurie (2015) and Cohodes et al (2016) show that children who benefited from the expansion of Medicaid and SCHIP in the 90s are more likely to graduate from high school and college in the long run.…”

Section: Introductionmentioning

confidence: 99%

The Affordable Care Act and College Enrollment Decisions

Jung

Shrestha

2016

SSRN Journal

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We investigate the effect of the extension of the federal dependent coverage mandate for young adults under the Affordable Care Act (ACA) on the college enrollment decisions of young Americans. The ACA removes the conditionality that young individuals need to be enrolled as full-time students in order to be able to remain on their parents' health insurance past the age of 18 and extends the coverage mandate to age 26 irrespective of student status. This expansion of the coverage mandate changes the incentives for the full-time and part-time college enrollment decisions of young individuals. We use panel data from the Survey of Income and Program Participation (SIPP) for the years 2003-2013 and estimate that the dependent coverage expansion under the ACA decreases the probability to enroll as full-time student by 2 to 3 percentage points. Furthermore we find that part-time college enrollment is unaffected by the new policy. The results from a difference-indifferences model are robust to changes in the model specification and become stronger when we increase the sample overlap between treatment and control groups using trimming based on propensity scores.

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“…Most research exploits the implementation (1960-70s) or the expansion (1980-90s) of Medicaid in the US, a federal-and state-funded programme helping disadvantaged families with children cover medical expenditures. The programme has been found to lead to a reduction in health limitations and chronic conditions at ages 18-21 (Thompson, 2017), mortality at age 28 (Brown et al, 2015), and mortality and disability in the 40s (Goodman-Bacon, 2016). Overall, access to Medicaid is found to be beneficial to participants' long-term health.…”

Section: Policiesmentioning

confidence: 99%

Developmental Origins of Health Inequality

2019

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Building on early animal studies, 20 th-century researchers increasingly explored the fact that early events-ranging from conception to childhood-affect a child's health trajectory in the long-term. By the 21st century, a wide body of research had emerged, incorporating the original 'Fetal Origins Hypothesis' into the 'Developmental Origins of Health and Disease'. Evidence from OECD countries suggests that health inequalities are strongly correlated with many dimensions of socioeconomic status, such as educational attainment; and that they tend to increase with age and carry stark intergenerational implications. Different economic theories have been developed to rationalize this evidence, with an overarching comprehensive framework still lacking. Existing models widely rely on human capital theory, which has given rise to separate dynamic models of adult and child health capital, within a production function framework. A large body of empirical evidence has also found support for the developmental origins of inequalities in health. On the one hand, studies exploiting quasi-random exposure to adverse events have shown long-term physical and mental health impacts of exposure to early shocks, including pandemics or maternal illness, famine, malnutrition, stress, vitamin deficiencies, maltreatment, pollution and economic recessions. On the other hand, studies from the 20th century have shown that early interventions of various content and delivery format improve life course health. Further, given that the most socioeconomically disadvantaged groups show the greatest gains, such measures can potentially reduce health inequalities. However, studies of long-term impacts, as well as the mechanisms via which shocks or policies affect health, and the dynamic interaction amongst them, are still lacking. Mapping the complexities of those early event dynamics is an important avenue for future research.

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Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?

Cited by 40 publications

References 33 publications

Still “Saving Babies”? The Impact of Child Medicaid Expansions on High School Completion Rates

Still “Saving Babies”? The Impact of Child Medicaid Expansions on High School Completion Rates

The Affordable Care Act and College Enrollment Decisions

Developmental Origins of Health Inequality

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