Full Citation
Title: Does SNAP Affect Medicaid Expenditures?
Citation Type: Miscellaneous
Publication Year: 2019
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Abstract: The Supplemental Nutrition Assistance Program (SNAP) and Medicaid target largely overlapping low-income populations and therefore may interact with each other. Participation in either program may make participation in the other less costly, but SNAP may also reduce demand for Medicaid coverage through impacts on health. The aggregate effects of SNAP on Medicaid enrollment and spending are therefore unclear a priori. The purpose of this paper is to estimate the aggregate impacts of SNAP participation on Medicaid enrollment and spending. We combine state-level information on SNAP participation, Medicaid outcomes, and state changes in SNAP and Medicaid policy over time. To address the endogeneity of SNAP participation, we employ a novel simulated eligibility instrumental variables framework exploiting variation in state policy generosity. We find evidence that higher SNAP participation greatly increases Medicaid enrollment. A one percentage point increase in the percentage of the population in SNAP results in a 1.1 percentage point increase in the percentage enrolled in Medicaid. Enrollment increases are larger for adults than children, and we find no evidence of enrollment increases for seniors. Further, we find no evidence that SNAP participation increases overall Medicaid spending per capita, but we do find that it decreases Medicaid spending per enrollee. These findings suggest that the lowered costs to SNAP participants of enrolling in Medicaid dominate any health or other effects of SNAP that would lower Medicaid enrollment, but marginal Medicaid enrollees of these kind cost less to cover than other enrollees on average.
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Authors: Courtemanche, Charles; Jones, Jordan; Marton, James; Rabbitt, Matthew
Publisher: University of Kentucky
Data Collections: IPUMS NHGIS
Topics: Health, Labor Force and Occupational Structure, Population Health and Health Systems
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