Association for Public Policy Analysis & Management

Recent papers have documented the importance of access to health care and the importance of the Affordable Care Act Expansion in the United-States on several variables such as mortality, health care access, crime and housing evictions. In this paper, we investigate the causal relationship between access to health care on foster care admissions and child neglect following state individual decisions to expand Medicaid coverage after the Affordable Care Act. Many of the newly eligible individuals for Medicaid-provided health insurance are parents at high risk of having kids sent to the foster care system. Our empirical strategy will use the variation in insurance eligibility generated by state decisions to expand Medicaid and the National Child Abuse and Neglect Data System (NCANDS) Child File. One important component of the Affordable Care Act is an alcohol and drug abuse help program. Alcohol and drugs consumption have been shown to affect foster care admissions (Gihleb, Giuntella, and Zhang, 2018). Our results show that the affordable care act expansion leads to a decrease in foster care admissions and a decrease in child neglect and maltreatment. This is important as foster care admissions and child neglects can have long term impacts on children.