Association for Public Policy Analysis & Management

The 2010 Patient Protection and Affordable Care Act was intended to broaden Medicaid eligibility to include most adults with incomes below 138% of the Federal Poverty Level by January 2014.  In preparation for this change, five states -- Connecticut, New Jersey, Minnesota, Washington, California -- and the District of Columbia expanded their Medicaid programs early, in 2010 and 2011.  In addition, Massachusetts expanded its Medicaid program in 2006, as part of a state health care reform initiative.

In this paper, we test whether these early Medicaid expansions affected receipt of Supplemental Security Income (SSI) and Social Security Disability Insurance Benefits (DI) for age group 18-64. The predicted impact of the Medicaid expansions is ambiguous because it could have affected outcomes via four competing channels, some of which would result in increases in SSI and DI and decreases in employment, and others which would do the opposite. We employ a synthetic control method to study the effect of early Medicaid expansions. Our preliminary findings indicate that the effect of early Medicaid expansions varies by states.