Closing the Gap at the Age of 65: Evidence from the Medicaid Expansions

33 Pages Posted: 17 Mar 2024

See all articles by Su Hwan Chung

Su Hwan Chung

Korea Development Institute (KDI)

Dajung Jun

Husson University

Date Written: March 15, 2024

Abstract

In the U.S., individuals in their early 60s often face limited healthcare access until they turn 65 and qualify for Medicare, a program providing universal health insurance coverage. This creates a gap in health insurance coverage at the age of 65, leading many to delay care to minimize out-of-pocket expenses. Our research examines whether Medicaid expansion in 2014, under the Affordable Care Act, for adults under 65 has reduced this gap and lowered the likelihood of care delay. Using a novel difference-in-differences-in-discontinuity method, we analyze two national survey datasets: the Health and Retirement Survey (HRS) and the American Community Survey (ACS). Our findings indicate that Medicaid expansion has decreased the gap in health insurance coverage at age 65 by 4.0 and 3.1 percentage points for HRS and ACS, respectively, representing reductions of 24.5 % and 19.6 % in the initial gap. This reduction is primarily due to changes in public health insurance coverage. However, although we note some associated shirts in health status and healthcare utilization, the majority of the estimates lack statistical significance.

Keywords: Medicare, Medicaid Expansions, Health Insurance, Affordable Care Act

JEL Classification: I13, I18, I12

Suggested Citation

Chung, Su Hwan and Jun, Dajung, Closing the Gap at the Age of 65: Evidence from the Medicaid Expansions (March 15, 2024). Available at SSRN: https://ssrn.com/abstract=4759778 or http://dx.doi.org/10.2139/ssrn.4759778

Su Hwan Chung

Korea Development Institute (KDI) ( email )

263 Namsejong-ro
Sejong-si 30149
Korea, Republic of (South Korea)

Dajung Jun (Contact Author)

Husson University ( email )

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