Medicaid Eligibility and Healthcare Utilization in Arizona: A Natural Experiment
*Names in bold indicate Presenter
This project, made possible by funding from the Robert Wood Johnson Foundation, follows the health-care utilization and insurance status of those Arizona Medicaid beneficiaries who lost their coverage as a result of this policy. To do this, we leverage access to enrollment data from the Arizona Health Care Cost Containment System (AHCCCS, the state Medicaid program) matched to Hospital and Emergency Department discharge data from the Arizona Department of Health Services (ADHS). Records are matched using administrative sources and cover the period 2008 through 2016, through the re-institution of the Prop 204 program in 2014 made possible by the Affordable Care Act. The longitudinal structure of the data means that beneficiaries act as their own controls, mitigating the impact of unobserved confounding factors on the analysis. Moreover, the extended time frame allows us to examine any impact of pent-up demand following lifting of enrollment freeze.
Specifically, we investigate the impact of AZ’s Medicaid enrollment freeze on emergency department visits and inpatient stays, and the extent to which the loss of coverage causes erstwhile beneficiaries to substitute the former for the later. We also investigate the impact of renewed coverage on these behaviors.
These questions are especially timely given current legislative debates over Medicaid funding and eligibility criteria occurring at both the federal and state levels. While ACA-funded Medicaid expansion has made health insurance coverage available to millions of individuals, many for the first time, a number of states are considering conditioning availability on work and training activities, among other qualifications. This project will provide much-needed evidence to this debate.