Association for Public Policy Analysis & Management

This paper examines how price and type of private coverage affect crowding out of private coverage in response to the Affordable Care Act state Medicaid expansions and considers implications for well-being using data on out-of-pocket health insurance premium payments and non-premium medical expenditures. Results suggest that the expansions led low-income individuals to switch out of costly employer-sponsored and direct-purchase insurance plans and onto Medicaid and zero-premium direct-purchase plans. Further results are consistent with the hypothesis that some newly eligible individuals previously did not seek any medical care or sought care but did not pay out of pocket for it.