Unuigbe Aig
The Graduate Center, City University of New York, New York, USA.
The University of Washington, Seattle, USA.
Int J Health Econ Manag. 2019 Dec;19(3-4):395-417. doi: 10.1007/s10754-019-09264-z. Epub 2019 Jan 31.
During the 1990s and early 2000s many states expanded Medicaid eligibility for parents particularly after the 1996 welfare reform. At the same time, welfare reform also put in place policies that limited the eligibility of recent immigrants for public programs including Medicaid. This paper evaluates the effects of these changes in Medicaid eligibility policy on the private and public health insurance coverage of immigrants as well as the overall insurance rate. It also looks at the effect on health care use and measures of health status. The findings indicate a significant increase in Medicaid coverage and an increase in the proportion insured overall with negligible crowd-out of private insurance. There is also an increase in the use of health care services. In the case of permanent residents, there is a diminished response to Medicaid eligibility changes possibly due to a "chilling effect".
在20世纪90年代和21世纪初,许多州扩大了医疗补助计划对父母的资格范围,尤其是在1996年福利改革之后。与此同时,福利改革还实施了一些政策,限制新移民参与包括医疗补助计划在内的公共项目的资格。本文评估了这些医疗补助计划资格政策变化对移民的私人和公共医疗保险覆盖范围以及总体保险率的影响。它还研究了对医疗保健使用和健康状况指标的影响。研究结果表明,医疗补助计划覆盖范围显著增加,总体参保比例上升,而私人保险的挤出效应可忽略不计。医疗保健服务的使用也有所增加。就永久居民而言,对医疗补助计划资格变化的反应有所减弱,这可能是由于“寒蝉效应”。