Abstract

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.

Document Type

Presentation

Publication Date

11-18-2014

Notes/Citation Information

A presentation at the American Public Health Association Annual Meeting in New Orleans, LA.

Funding Information 

  • Funded by the Robert Wood Johnson Foundation through the National Coordinating Center for Public Health Services & Systems Research
  • Supported by the NIH National Center for Advancing Translational Science through the Kentucky Center for Clinical and Translational Science

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