Association for Public Policy Analysis & Management

Panel: Medicaid and Human Capital

(Health Policy)

Despite the intense policy debate over the status and future of Medicaid, and public health insurance in the US in general, we don’t have a complete understanding of the effects of Medicaid. While past work has focused on evaluating the effect of Medicaid on access to healthcare and health outcomes, only a handful of studies have investigated the spillover effects of Medicaid on non-health human capital outcomes such as education and earnings. Human capital theory predicts that Medicaid can meaningfully impact the educational attainment of infants and children who benefit from Medicaid because it may lead to significant improvements in health and due to increased financial stability in their households. Medicaid family planning programs can also impact the educational attainment of young women by helping them avoid unplanned pregnancies. We propose a panel which seeks to highlight research which attempts to fill this gap by assessing the effects of Medicaid on human capital outcomes.

The first paper in the session “The Short- and Long-Term Effects of a Large-Scale Prenatal Care Intervention” evaluates the effect of the Comprehensive Perinatal Services Program, a program that provides “enhanced” services to low-income pregnant women receiving routine obstetrical care under Medicaid and includes comprehensive risk assessments and targeted support services. The paper evaluates the effects of this large-scale prenatal care intervention on health outcomes at birth as well as later life outcomes, including mortality, disability, educational attainment, labor force participation, income, and participation in public programs.

The second paper in the session “Early Life Medicaid Eligibility and Academic Outcomes” studies the effect of Medicaid eligibility expansion between the ages of 8-14 on academic outcomes measured when the children are 13 years of age. This study uses administrative school records to estimate the effects of the Medicaid expansion on academic and health outcomes including the grade level of the child, whether the child is below grade, and measures of reading proficiency and math proficiency in addition to disability and absences from school.

The third paper in the session “Expanded Access to Affordable Contraception and Women’s Educational Attainment” examines the effects of state Medicaid family planning programs on women’s educational attainment. Between 1997 and 2010, 21 states implemented waivers allowing low-income women not eligible for comprehensive Medicaid benefits to access contraception at low or no cost. This study evaluates the effect of this expansion of access to affordable contraception during the teen years for women’s educational attainment, age at first birth and parenthood.

The different studies analyze different aspects of the Medicaid program which can affect educational attainment and human capital outcomes through a multitude of channels which could shed light on the mechanisms through which Medicaid affects these outcomes. Together these studies are also complementary in that they analyze the effects of exposure to Medicaid programs at different times in a person’s life including in utero, during childhood and during the teen years.