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Social and Behavioral Sciences Commons™
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Full-Text Articles in Social and Behavioral Sciences
Medicaid Crowd-Out Of Other Public Health Spending: Modeling Economic & Health Effects, Glen P. Mays
Medicaid Crowd-Out Of Other Public Health Spending: Modeling Economic & Health Effects, Glen P. Mays
Health Management and Policy Presentations
MOTIVATION: Thirty states are expanding Medicaid eligibility under the Affordable Care Act (ACA) as of 2015, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who enroll in Medicaid. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to channel their health-related spending to Medicaid rather than to other …
Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen P. Mays
Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen P. Mays
Health Management and Policy Presentations
In this paper we estimate the causal impact of state Medicaid enrollment expansions and expenditures on state and local resources allocated to other public health programs and services. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.
Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays
Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays
Health Management and Policy Presentations
Uncertainty about the magnitude and timing of economic returns associated with spending on public health services has contributed to policy debates about the optimal role of the federal government in financing these services.