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Title: Welcome Mat Effects for Older Adults: The Impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid
Citation Type: Conference Paper
Publication Year: 2019
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Abstract: We examine whether Medicaid expansions to working-age adults as part of the Affordable Care Act (ACA) increased Medicaid participation by low-income older adults. While many published studies have examined so-called "welcome mat" effects in other populations, they have not explicitly considered persons dually eligible for Medicare and Medicaid. A potential explanation for welcome mat effects in our setting is a dynamic process that is unique to older adults; specifically, Medicaid expansions that occur when an individual is under age 65 could increase Medicaid participation when they become age eligible for Medicare. We estimate models of Medicaid participation using 2010-2016 data from the American Community Survey and state variation in ACA-related Medicaid expansions. We find that Medicaid expansions to working-age adults increased Medicaid participation among low-income older adults by 1.9 percentage points, or 4.7%. We also find evidence of a dynamic welcome mat effect: low-income older adults in expansion states who were young enough to be age-eligible for Medicaid expansions in 2014 were 4 percentage points, or 9.5%, more likely to be dually enrolled in Medicaid when they turned age 65 in 2015 or 2016 than similar age adults.
Url: https://www.bu.edu/econ/files/2019/03/MMS_12_19_18.pdf
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Authors: Mcinerney, Melissa; Mellor, Jennifer M; Sabik, Lindsay M
Conference Name: Health Economics Workshop
Publisher Location: Cambridge, MA
Data Collections: IPUMS USA
Topics: Health, Population Health and Health Systems
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