Medicaid Expansion For Adults Had Measurable 'Welcome Mat' Effects On Their Children
Medicaid Expansion For Adults Had Measurable 'Welcome Mat' Effects On Their Children
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DOI：
10.1377/hlthaff.2017.0347
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发表时间：
2017-09-01
期刊：
影响因子：
9.7
通讯作者：
Moriya, Asako S.
中科院分区：
文献类型：
--
作者：
Hudson, Julie L.;Moriya, Asako S.
在《平价医疗法案》(ACA)实施之前，低收入家庭的大多数儿童已经有资格通过医疗补助或儿童健康保险计划获得公共保险。自ACA实施以来，观察到这些儿童的覆盖率增加，这表明该立法可能对符合条件的儿童入学人数产生重要的溢出或“欢迎”影响。这项研究使用了2013-15年美国社区调查的数据，首次在国家层面(分析)估计了欢迎垫对ACA后儿童覆盖率的影响。我们估计，通过这些影响，71万名低收入儿童获得了保险。这项研究也首次表明，根据ACA，父母获得医疗补助的资格与他们孩子的欢迎垫效果之间存在联系。在父母根据ACA扩展到成年人获得医疗补助资格的儿童中，欢迎垫的影响最大。这些儿童的公共覆盖率增加了5.7个百分点--是父母在ACA前后都没有资格享受医疗补助的儿童的2.7个百分点增幅的两倍多。最后，我们估计，如果所有州都采用了扩大医疗补助的计划，那么将有额外20万低收入儿童获得医保。
Before the implementation of the Affordable Care Act (ACA), most children in low-income families were already eligible for public insurance through Medicaid or the Children's Health Insurance Program. Increased coverage observed for these children since the ACA's implementation suggest that the legislation potentially had important spillover or "welcome mat" effects on the number of eligible children enrolled. This study used data from the 2013-15 American Community Survey to provide the first national-level (analytical) estimates of welcome-mat effects on children's coverage post ACA. We estimated that 710,000 low-income children gained coverage through these effects. The study was also the first to show a link between parents' eligibility for Medicaid and welcome-mat effects for their children under the ACA. Welcome-mat effects were largest among children whose parents gained Medicaid eligibility under the ACA expansion to adults. Public coverage for these children increased by 5.7 percentage points-more than double the 2.7-percentage-point increase observed among children whose parents were ineligible for Medicaid both pre and post ACA. Finally, we estimated that if all states had adopted the Medicaid expansion, an additional 200,000 low-income children would have gained coverage.