Expanding Public Health Insurance to Parents

Michelle Marcus and Xuan Zhang

American Journal of Health Economics, 2026, vol. 12, issue 2, 260 - 288

Abstract: Expanding public health insurance to parents may not only benefit parents, but also have spillover effects on their children. In this paper, we exploit the natural experiment arising from the Affordable Care Act to estimate the causal effects of expanding public health insurance to low-income parents on the well-being of parents and their children. Using a difference-in-differences model with data from the 2010–17 National Health Interview Surveys, we find significant improvements in health-care access, increases in health-care utilization, reductions in financial burden, and a slight improvement in health status for low-income parents. For low-income children in the Medicaid expansion states, we find decreases in both emergency care utilization and hospitalizations. These findings suggest short-term positive spillover effects of parental insurance coverage on low-income children’s well-being via improved health-care utilization.

Date: 2026
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