Abstract
In this chapter we estimate the impact of the major components of the ACA (Medicaid expansion, subsidized Marketplace plans, and insurance market reforms) on disparities in insurance coverage after four years. We use data from the 2011-2017 waves of the American Community Survey (ACS), with the sample restricted to nonelderly adults. Our methods feature a difference-in-difference-in-differences model, developed in the recent ACA literature, which separately identifies the effects of the nationwide and Medicaid expansion portions of the law. The differences in this model come from time, state Medicaid expansion status, and local area pre-ACA uninsured rate. We stratify our sample separately by income, race/ethnicity, marital status, age, and gender, in order to examine access disparities. After four years, the fully implemented ACA (i.e., the national components of the ACA combined with the Medicaid expansion) eliminated 44 percent of the coverage gap across income groups, with the Medicaid expansion accounting for this entire reduction. The fully implemented ACA also reduced coverage disparities across racial groups by 26.7 percent, across marital status by 45 percent, and across age groups by 44 percent, with these changes being partly attributable to both the Medicaid expansion and nationwide components of the law.
Original language | English |
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Title of host publication | Medicaid |
Subtitle of host publication | Politics, Policy, and Key Issues |
Pages | 21-51 |
Number of pages | 31 |
ISBN (Electronic) | 9781536182309 |
State | Published - Jan 1 2020 |
Bibliographical note
Publisher Copyright:© 2020 by Nova Science Publishers, Inc.
Keywords
- Affordable care act
- Disparities in insurance coverage
- Health care finance
- Medicaid
ASJC Scopus subject areas
- General Health Professions
- General Medicine