Description: Department Seminars: Kosali Simon (University of Indiana)

Location: Virtual, TBA

Contact Person: John Winters 

Title: "When Federal and State Policies Meet: State ACA Medicaid Expansions and the Medicaid Continuity of Coverage rules during the COVID-19 Public Health Emergency (PHE)"

Abstract: 

Over 90 Million individuals are now enrolled in Medicaid and CHIP as of August 2022, an increase of nearly 20 Million individual since February 2020.^[1]

Medicaid program plays a critical role in health equity for the US, and Medicaid and its expansions are considered a key reason that the COVID public health crisis did not lead to a health insurance crisis.

Prior to the federal PHE Medicaid policy change, the largest changes occurred through the Affordable Care Act state Medicaid expansions.  In this paper, we examine the way the these two Medicaid expansions interact with each other. Specifically, we examine the different experience of similar individuals who reside in states that expanded Medicaid prior to the PHE vs in states that did not expand Medicaid, in the period after the PHE relative to the prior period. We also explore aggregate results on coverage in administrative sources relative to survey sources.  Administrative counts show larger increases than survey responses, leading people to question whether self reporting is lower because people are unaware and not using Medicaid. Outcomes studies in this paper include health insurance coverage sources, as well as health care utilization (total dollars spent as well as prescription drug utilization). Preliminary results show that Medicaid transfers to states increased faster in expansion states than non-expansion states, after 2020 relative to before.  Although both expansion and non expansion states experienced rapid drops in health care utilization in March 2020, the subsequent recovery has been larger in Medicaid expansion states, indicating that the PHE Medicaid expansion advantaged states that had expanded Medicaid prior to the PHE.