Association for Public Policy Analysis & Management

To address the adverse selection problem in health insurance, the United States has required all individuals to be covered by health insurance; to help poor individuals and households obtain health insurance, Medicaid has been expanded. However, expanding Medicaid coverage via increased eligibility levels could still leave a segment of the poor population without Medicaid - poor Limited English Proficient (LEP) individuals and households will still not have insurance if they are unable to understand the Medicaid application procedure. To help LEP migrants obtain Medicaid, some states have enacted language access laws requiring Medicaid agencies provide translators or translated documents. In this paper, I take advantage of state heterogeneity to examine whether these forts do indeed increase Medicaid take-up rates. I find that language access improves Medicaid take-up rates among likely LEP migrants without crowding out private health insurance. There is some variation in efficacy across states, with some evidence that California and New York are the main drivers of the increased take-up rates. Lastly, I find that even though many of these translation services primarily target Spanish-speakers, the laws might not be as helpful to Spanish-speaking migrants.