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The Impact of the ACA Medicaid Expansion on Disability Program Applications

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  • Lucie Schmidt
  • Lara Shore-Sheppard
  • Tara Watson
Abstract
The Affordable Care Act (ACA) expanded the availability of public health insurance, decreasing the relative benefit of participating in disability programs but also lowering the cost of exiting the labor market to apply for disability program benefits. In this paper, we explore the impact of expanded access to Medicaid through the ACA on applications to the Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) programs. Using the fact that the Supreme Court decision of June 2012 made the Medicaid expansion optional for the states, we compare changes in county-level SSI and SSDI caseloads in contiguous county pairs across a state border. We find no significant effects of the Medicaid expansion on applications or awards to either SSI or SSDI, and can reject economically meaningful impacts of Medicaid expansions on applications to disability programs.

Suggested Citation

  • Lucie Schmidt & Lara Shore-Sheppard & Tara Watson, 2019. "The Impact of the ACA Medicaid Expansion on Disability Program Applications," NBER Working Papers 26192, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:26192
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    References listed on IDEAS

    as
    1. Burns, Marguerite & Dague, Laura, 2017. "The effect of expanding Medicaid eligibility on Supplemental Security Income program participation," Journal of Public Economics, Elsevier, vol. 149(C), pages 20-34.
    2. Chatterji, Pinka & Li, Yue, 2017. "Early coverage expansions under the Affordable Care Act and Supplemental Security Income participation," The Journal of the Economics of Ageing, Elsevier, vol. 10(C), pages 75-83.
    3. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2016. "Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States," NBER Working Papers 22182, National Bureau of Economic Research, Inc.
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    11. Robert Kaestner & Bowen Garrett & Jiajia Chen & Anuj Gangopadhyaya & Caitlyn Fleming, 2017. "Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(3), pages 608-642, June.
    12. Mark Duggan & Melissa S. Kearney & Stephanie Rennane, 2015. "The Supplemental Security Income Program," NBER Chapters, in: Economics of Means-Tested Transfer Programs in the United States, Volume 2, pages 1-58, National Bureau of Economic Research, Inc.
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    15. Lucas Goodman, 2017. "The Effect of the Affordable Care Act Medicaid Expansion on Migration," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(1), pages 211-238, January.
    16. Nicole Maestas & Kathleen J. Mullen & Alexander Strand, 2014. "Disability Insurance and Health Insurance Reform: Evidence from Massachusetts," American Economic Review, American Economic Association, vol. 104(5), pages 329-335, May.
    17. Lucie Schmidt & Lara Shore-Sheppard & Tara Watson, 2019. "The Impact of Expanding Public Health Insurance on Safety Net Program Participation: Evidence from the ACA Medicaid Expansion," NBER Working Papers 26504, National Bureau of Economic Research, Inc.
    18. Anne Case & Angua Deaton, 2015. "Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century," Working Papers 15078.full.pdf, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
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    20. Levere, Michael & Orzol, Sean & Leininger, Lindsey & Early, Nancy, 2019. "Contemporaneous and long-term effects of children’s public health insurance expansions on Supplemental Security Income participation," Journal of Health Economics, Elsevier, vol. 64(C), pages 80-92.
    21. Katherine Baicker & Amy Finkelstein & Jae Song & Sarah Taubman, 2014. "The Impact of Medicaid on Labor Market Activity and Program Participation: Evidence from the Oregon Health Insurance Experiment," American Economic Review, American Economic Association, vol. 104(5), pages 322-328, May.
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    Cited by:

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    2. Andre, Jennifer & Braga, Breno & Martinchek, Kassandra & McKernan, Signe-Mary, 2024. "The effects of state utility shutoff moratoria on credit delinquencies during the COVID-19 pandemic," Journal of Economics and Business, Elsevier, vol. 129(C).
    3. Hamish Low & Luigi Pistaferri, 2020. "Disability Insurance: Theoretical Trade‐Offs and Empirical Evidence," Fiscal Studies, John Wiley & Sons, vol. 41(1), pages 129-164, March.
    4. Heim, Bradley & Lurie, Ithai & Mullen, Kathleen J. & Simon, Kosali, 2021. "How Much Do Outside Options Matter? The Effect of Subsidized Health Insurance on Social Security Disability Insurance Benefit Receipt," Journal of Health Economics, Elsevier, vol. 76(C).
    5. Becky Staiger & Madeline Helfer & Jessica Van Parys, 2024. "The effect of Medicaid expansion on the take‐up of disability benefits by race and ethnicity," Health Economics, John Wiley & Sons, Ltd., vol. 33(3), pages 526-540, March.
    6. Messel, Matt & Swensen, Isaac & Urban, Carly, 2023. "The effects of expanding access to mental health services on SS(D)I applications and awards," Labour Economics, Elsevier, vol. 81(C).
    7. Guldi, Melanie & Hamersma, Sarah, 2023. "The effects of pregnancy-related Medicaid expansions on maternal, infant, and child health," Journal of Health Economics, Elsevier, vol. 87(C).
    8. Lindsey Rose Bullinger, 2021. "Child Support and the Affordable Care Act's Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(1), pages 42-77, January.
    9. Maestas, Nicole & Mullen, Kathleen J. & Strand, Alexander, 2021. "The effect of economic conditions on the disability insurance program: Evidence from the great recession," Journal of Public Economics, Elsevier, vol. 199(C).
    10. Xiuming Dong & Johanna Catherine Maclean & David Powell, 2024. "Social Insurance Spillovers: Evidence From Paid Sick Leave Mandates and Workers' Compensation," NBER Working Papers 32751, National Bureau of Economic Research, Inc.
    11. Lucie Schmidt & Lara Shore-Sheppard & Tara Watson, 2019. "The Impact of Expanding Public Health Insurance on Safety Net Program Participation: Evidence from the ACA Medicaid Expansion," NBER Working Papers 26504, National Bureau of Economic Research, Inc.

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    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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