BEYOND THE NUMBERS
Expanding Medicaid to low-income adults under health reform improves the financial well-being of those newly eligible for Medicaid, a recent analysis published by the National Bureau of Economic Research (NBER) finds. Adults in the geographic areas within expansion states with the largest share of low-income, uninsured individuals have fewer debts sent to third-party collection agencies — and smaller total debts in collection — than adults in similar areas of non-expansion states. Improved financial well-being can translate into greater access to credit, higher savings, and higher consumption of goods and services.
This study, the first national study on Medicaid’s impact on the financial well-being specifically of adults made eligible under health reform, adds to a growing body of research on Medicaid’s benefits for families’ financial stability. For example:
- Evaluation of the Oregon Health Insurance Experiment finds that adults enrolled in Oregon’s Medicaid program through a lottery are 40 percent less likely to borrow money or skip paying bills in order to pay for medical care — and 25 percent less likely to have an unpaid medical bill sent to a collection agency — than those eligible but not enrolled.
- Survey data from the Centers for Disease Control and Prevention and the Commonwealth Fund show that the share of low-income adults who have had trouble paying a medical bill has fallen since the Medicaid expansion took effect in 2014.
The NBER analysis examined people likely eligible for Medicaid rather than those actually enrolled — a common limitation of research in this area that tends to understate the effects of Medicaid enrollment. After adjusting their estimates using basic assumptions about Medicaid participation among those eligible, the authors estimate that Medicaid enrollment reduced total non-medical debt in collections by $600 to $1,000 per person.
Medicaid’s contribution to enrollees’ financial well-being is just one reason for states to expand coverage to low-income adults under health reform. The Medicaid expansion has also improved access to care, produced state savings, and supported health care providers. Thirty-one states plus the District of Columbia have expanded coverage, with Louisiana poised to do so in July.