Association for Public Policy Analysis & Management

Panel: Welcome Mat Effects of Medicaid Expansions

(Health Policy)

Medicaid coverage of low-income adults aged 19-64 has expanded dramatically since 2010. In addition to increasing coverage among the targeted population, Medicaid expansions may increase take-up rates among other groups already eligible for the program. These spillover or “welcome mat” effects may arise from increased awareness of health insurance programs or streamlined application processes, among other factors. Expectations regarding the budgetary implications of welcome mat effects may influence state decisions regarding Medicaid expansion, thus motivating the need for timely research. The three papers in this session examine welcome mat effects in different segments of the already-eligible population. First, Moriya and Hudson examine welcome mat effects among Medicaid-eligible children, who experienced no change in their own eligibility status. Using 2013-2014 ACS data, they compare changes in eligible children’s coverage over time in expansion states versus non-expansion-states. Second, Gooptu, Moriya, Simon, and Sommers examine welcome mat effects among working-age, non-disabled parents with incomes below pre-ACA Medicaid eligibility thresholds. Using data from the 2008-2014 American Community Survey (ACS), they examine Medicaid participation among this group before and after the ACA’s Medicaid expansions, and in expansion versus non-expansion states. Third, McInerney, Mellor, and Sabik examine welcome mat effects among Medicaid-eligible seniors, another group that experienced no change in own eligibility status. Using ACS data from 2008-2014, they examine Medicaid participation by eligible low-income seniors before and after the ACA’s early and full Medicaid expansions in expansion versus non-expansion states. Preliminary results from these studies provide important evidence of welcome mat effects.