Health Insurance Generosity and Conditional Coverage: Evidence from Medicaid and Managed Care in Kentucky

39 Pages Posted: 16 Jul 2014

See all articles by James Marton

James Marton

Georgia State University - Andrew Young School - Department of Economics

Aaron Yelowitz

University of Kentucky - Department of Economics

Date Written: May 2014

Abstract

This paper estimates the impact of the introduction of Medicaid managed care (MMC) on the formal Medicaid participation of children. We employ a quasi-experimental approach exploiting the location-specific timing of MMC implementation in Kentucky. Using data from the March Current Population Survey from 1995-2003, our findings suggest that the introduction of MMC increases the likelihood of being uninsured and decreases formal Medicaid participation. This finding is consistent with an increase in "conditional coverage" – waiting until medical care is needed to sign up or re-enroll in Medicaid. These effects are concentrated among low-income children and absent for high-income children. We find no evidence of "crowd-in" – substituting private coverage for Medicaid. These results are robust to multiple placebo tests and imply the potential for less formal participation (i.e. more conditional coverage) among the ACA Medicaid expansion population (which is likely to be primarily covered under MMC) than is typically predicted.

Keywords: Medicaid, Managed Care, Child Health, Conditional Coverage

JEL Classification: I18, I38, J13

Suggested Citation

Marton, James and Yelowitz, Aaron, Health Insurance Generosity and Conditional Coverage: Evidence from Medicaid and Managed Care in Kentucky (May 2014). Andrew Young School of Policy Studies Research Paper Series No. 14-09. Available at SSRN: https://ssrn.com/abstract=2466524 or http://dx.doi.org/10.2139/ssrn.2466524

James Marton (Contact Author)

Georgia State University - Andrew Young School - Department of Economics ( email )

P.O. Box 3992
Atlanta, GA 30302-3992
United States

Aaron Yelowitz

University of Kentucky - Department of Economics ( email )

Lexington, KY 40506
United States

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