Fry Carrie E, McGuire Thomas G, Frank Richard G
Harvard University.
Department of Health Care Policy at Harvard Medical School.
RSF. 2020 Jul;6(2):244-263. doi: 10.7758/rsf.2020.6.2.11.
Spillovers from the Affordable Care Act Medicaid expansion to other social-sector outcomes have received little attention. One that may be especially salient for public policy is the impact of expanded eligibility on jail-related outcomes. This study compares recidivism outcomes in three non-expansion counties to nearby expansion counties before and after Medicaid expansion. Using forty-eight months of arrest data from six urban county jails, we conduct comparative interrupted time series analyses to describe changes in the probability of rearrest and the number of arrests before and after Medicaid expansion. Consistent with previous literature, we find mixed results. In two case studies, Medicaid expansion is associated with decreased rates of recidivism. In the other, we find differential increases in jail-based recidivism after Medicaid expansion. We use contextual information from site visits and stakeholder interviews to understand the factors that may mediate and moderate the relationship between Medicaid expansion and return to jail.
《平价医疗法案》中医疗补助扩大计划对其他社会部门成果的溢出效应很少受到关注。对公共政策而言，一个可能特别突出的方面是资格扩大对与监狱相关成果的影响。本研究比较了三个未扩大医疗补助的县与附近扩大医疗补助的县在医疗补助扩大前后的累犯结果。利用来自六个城市县监狱的48个月逮捕数据，我们进行了比较间断时间序列分析，以描述医疗补助扩大前后再次被捕概率和逮捕次数的变化。与先前的文献一致，我们得到了复杂的结果。在两个案例研究中，医疗补助扩大与累犯率下降有关。在另一个案例中，我们发现医疗补助扩大后基于监狱的累犯有不同程度的增加。我们利用实地考察和利益相关者访谈的背景信息，来理解可能调节和缓和医疗补助扩大与重返监狱之间关系 的因素。
