Naomi Zewde (
Christopher Wimer is codirector of the Center on Poverty and Social Policy, Columbia University School of Social Work.
Health Aff (Millwood). 2019 Jan;38(1):132-138. doi: 10.1377/hlthaff.2018.05155.
Out-of-pocket spending on health care pushed over 10.5 million Americans into poverty in 2016. Medicaid helps offset this risk by providing medical coverage to millions of poor and near-poor children and adults and thereby constraining out-of-pocket medical spending. This article examines whether recent state-level expansions to the Medicaid program resulted in reductions in poverty and whether future changes to the program are likely to have similar impacts on poverty. Using a difference-in-differences research design, we found that the recent Medicaid expansion caused a significant reduction in the poverty rate. Moreover, by simulating a counterfactual poverty rate for a hypothetical world without Medicaid coverage, we found that the program's antipoverty impact grew over the past decade independent of expansion, by shielding beneficiaries from growing out-of-pocket spending. Future expansions or retractions of Medicaid are likely to produce associated effects on poverty.
2016 年，医疗保健自付支出使超过 1050 万美国人陷入贫困。医疗补助计划通过为数百万贫困和接近贫困的儿童和成年人提供医疗保障，从而限制了自付医疗支出，有助于降低这种风险。本文探讨了最近州级医疗补助计划的扩大是否导致贫困率降低，以及该计划未来的变化是否可能对贫困产生类似影响。使用差异中的差异研究设计，我们发现最近的医疗补助计划扩张导致贫困率显著下降。此外，通过模拟一个假设的没有医疗补助覆盖的假设世界的反事实贫困率，我们发现该计划的扶贫影响在过去十年中不断扩大，因为它使受益人免受不断增加的自付支出的影响。未来医疗补助计划的扩大或收缩可能会对贫困产生相关影响。
