Moving For Medicaid? Recent Eligibility Expansions Did Not Induce Migration From Other States
Moving For Medicaid? Recent Eligibility Expansions Did Not Induce Migration From Other States
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DOI：
10.1377/hlthaff.2013.0910
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发表时间：
2014-01-01
期刊：
影响因子：
9.7
通讯作者：
Sommers, Benjamin D.
中科院分区：
文献类型：
--
作者：
Schwartz, Aaron L.;Sommers, Benjamin D.
从2014年开始，许多放弃《平价医疗法案》扩大医疗补助范围的州的低收入成年居民，如果搬到一个选择扩大医疗补助范围的州，将有资格享受该计划。其中一些人可能会移民接受保险，从而增加了扩大该计划的州的成本。这被称为“福利磁铁”假说，即社会计划的地理差异导致福利领取者向福利更慷慨或更有资格的地方迁移。为了调查这种溢出效应是否可能，我们使用了当前人口调查的数据来研究亚利桑那州、缅因州、马萨诸塞州和纽约最近扩大公共保险之前和之后低收入人群的移民模式。使用差异-无差异分析迁移在扩张和控制状态，我们没有发现显着的迁移效应的证据。我们的首选估计足够精确，可以排除扩张状态下每年超过1，600人的净移民影响。这些结果表明，移民将不会是人们在目前的扩张下获得医疗补助的常见方式，并且州际移民不太可能成为选择扩大其计划的州的重要成本来源。
Starting in 2014, many low-income adult residents of states that forgo the Affordable Care Act's expansion of Medicaid would be eligible for that program if they moved to a state that had chosen to expand its coverage. Some of these people may migrate to receive coverage, thereby increasing costs for states that have expanded the program. This is known as the "welfare magnet" hypothesis, a claim that geographic variation in social programs induces the migration of welfare recipients to places with more generous benefits or eligibility. To investigate whether such spillover effects are likely, we used data from the Current Population Survey to examine the migration patterns of low-income people before and after recent expansions of public insurance in Arizona, Maine, Massachusetts, and New York. Using difference-indifferences analysis of migration in expansion and control states, we found no evidence of significant migration effects. Our preferred estimate was precise enough to rule out net migration effects of larger than 1,600 people per year in an expansion state. These results suggest that migration will not be a common way for people to obtain Medicaid coverage under the current expansion and that interstate migration is not likely to be a significant source of costs for states choosing to expand their programs.