State responses to federal matching grants: The case of medicaid

• 成果类型: Article
• 署名作者: Leung, Pauline
• 署名单位: Cornell University; Cornell University
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2022.104746
• 发表日期: 2022
• 关键词: Medicaid; Matching grants

摘要

While Medicaid is currently financed by open-ended matching, in which the federal government's con-tribution is uncapped, there has been interest in transforming the financing structure to block grants, which limits federal cost-sharing to a fixed amount. To understand the implications of this reform, I mea-sure the effect of match rates on Medicaid spending by using the variation induced by a kink in the match rate formula. I find that a percentage point increase in the federal match raises per-beneficiary spending by 3 to 6 percent and that these results are driven by high-spending states. Using this estimate, I discuss the welfare impact of a block grant reform.(c) 2022 Elsevier B.V. All rights reserved.