Medicaid Expansion and the Unemployed

Abstract

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The Relationship Between Unemployment and Health Insurance Coverage

“…Consistent with previous research, 34 there appears to be an even stronger relationship between unemployment and increased Medicaid enrollment following expansion. The tripledifference terms (ie, unemployment × expansion × years 2014 −2019) suggest expanding Medicaid further weakened the relationship between employment status and coverage through additional access to Medicaid (columns 4, 5, 7, and 9).…”

“…We use PUMA-level unemployment rates from the 50% random draw of ACS data so changes in coverage status are driven by plausibly exogenous (ie, with respect to individuals in our analytical sample) market-level employment conditions. Although there is limited evidence to suggest labor force participation declined following the ACA's coverage expansions, [30][31][32][33][34] labor force attachment could be influenced by the availability of non-ESI based coverage options in ways we have yet to observe in the scholarly literature. For this reason, we apply this approach to remove bias from using "own employment status" to construct the local unemployment rates.…”

The Impact of Job and Insurance Loss on Prescription Drug use: A Panel Data Approach to Quantifying the Health Consequences of Unemployment During the Covid-19 Pandemic

“…Looking toward policy solutions, we find that better access to social safety nets such as Medicaid can help smooth health care consumption during a negative economic shock such as unemployment. Our findings are consistent with previous literature studying the role of Medicaid during economic downturns 25 , 39 . Given that unemployment affects medication adherence through increased out-of-pocket costs, policy solutions should focus on the patients most vulnerable to cost-related nonadherence.…”

Sliding into Safety Net Participation: A Unified Analysis Across Multiple Programs

“…All of these programs can be applied for at any point 4 Key exceptions are Dague et al (2017), who find decreases in employment leading up to Medicaid enrollment, and Deshpande et al (2021), who find that SSDI application coincides with sharp increases in the rates of various adverse financial events. Hastings and Shapiro (2018) and Buchmueller et al (2021) also document patterns in grocery store consumption around SNAP receipt and access to health care around Medicaid receipt, respectively. A related, but distinct, literature also studies the dynamics of program participation (Blank and Ruggles 1996;Grogger 2004;Ham et al 2016).…”