The Impact of Expanding Public Health Insurance on Safety Net Program Participation: Evidence From the ACA Medicaid Expansion

Lucie Schmidt, Lara Shore-Sheppard and Tara Watson

Working Papers from U.S. Census Bureau, Center for Economic Studies

Abstract: We examine spillover effects from the ACA Medicaid expansion to public programs providing cash and food assistance. We consider program participation in contiguous county pairs crossing state borders, where one state took up the Medicaid expansion and the other did not, allowing us to better control for local economic trends that could affect program participation. We find that the Medicaid expansion increased participation in food assistance and one of the cash programs, with impacts mainly due to participation conditional on eligibility, rather than from labor supply responses. Our results demonstrate the potential for spillovers across safety net programs.

Date: 2026-05
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https://www2.census.gov/library/working-papers/2026/adrm/ces/CES-WP-26-32.pdf First version, 2026 (application/pdf)

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Persistent link: https://EconPapers.repec.org/RePEc:cen:wpaper:26-32

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