The Impact of Medicaid on Medical Utilization in a Vulnerable Population: Evidence from COFA Migrants

Timothy Halliday, Randall Akee, Tetine Sentell, Megan Inada and Jill Miyamura

No 26030, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: In March 2015, the State of Hawaii stopped covering the vast majority of migrants from countries belonging to the Compact of Free Association (COFA) in the state Medicaid program. COFA migrants were instead required to obtain private insurance in the exchanges established under the Affordable Care Act. Using statewide administrative hospital discharge data, we show that Medicaid-funded hospitalizations and emergency room visits declined in this population by 69% and 42% after the expiration of Medicaid eligibility. This decrease occurred despite the fact that low-income COFA households were eligible for state-funded premium coverage for private insurance. Utilization funded by private insurance did increase, but not enough to offset the declines in Medicaid-funded utilization. Uninsured ER visits increased as a consequence of the expiration of Medicaid benefits. Paradoxically, we also find a substantial increase in Medicaid-funded ER visits by infants after the expiration of benefits.

JEL-codes: I10 I14 J61 (search for similar items in EconPapers)
Date: 2019-07
New Economics Papers: this item is included in nep-hea, nep-ias and nep-mig
Note: CH EH LS PE
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Citations: View citations in EconPapers (3)

Published as Timothy J. Halliday & Randall Q. Akee, 2020. "The impact of Medicaid on medical utilization in a vulnerable population: Evidence from COFA migrants," Health Economics, vol 29(10), pages 1231-1250.

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Journal Article: The impact of Medicaid on medical utilization in a vulnerable population: Evidence from COFA migrants (2020)
Working Paper: The Impact of Medicaid on Medical Utilization in a Vulnerable Population: Evidence from COFA Migrants (2019)
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