The goal of this study is to inform expansion and non-expansion states of the effect of Medicaid expansion on out-of-pocket spending and the overall resources available to families. Using data from the 2014-2016 Current Population Survey Annual Social and Economic Supplement, the applicants will conduct a difference-in-differences analysis, using the 2014 Medicaid expansion as a natural experiment, to address the following research questions:
Compared to marketplace coverage, what is the impact of the Medicaid expansion on reducing premium and non-premium out-of-pocket health spending among low-income adults with incomes between 100 and 138% FPL? In other words, among those in this income group, how much would out-of-pocket health spending in nonexpansion states change if states either expanded Medicaid or made Marketplace benefits and cost-sharing comparable with Medicaid?
What is the impact of the Medicaid expansion on out-of-pocket health spending among adults with incomes below 100% FPL in expansion states, relative to similar adults in nonexpansion states without access to Medicaid or Marketplace subsidies?
How do these changes in out-of-pocket spending affect the overall resources available to families?
The State Health Access Data Assistance Center (SHADAC) is a program of the Robert Wood Johnson Foundation and a part of the Health Policy and Management Division of the School of Public Health at the University of Minnesota.