Targeting in Medicaid: The costs and enrollment effects of Medicaid's citizenship documentation requirement

• 成果类型: Article
• 署名作者: Sommers, Benjamin D.
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2009.11.004
• 发表日期: 2010
• 页码: 174-182
• 关键词: Medicaid; immigration; health insurance; Target efficiency

摘要

The Deficit Reduction Act of 2005 imposed a federal requirement that all individuals provide citizenship documentation when applying for or renewing Medicaid coverage This represented a change in policy for 46 states Using differences-m-differences to analyze data from the Current Population Survey (2004-2008), this paper shows that the policy reduced Medicaid enrollment among non-citizens, as intended, and did not significantly affect citizens One-in-four adult non-citizens in Medicaid (390,000 total) and one-m-eight child non-citizens (81,000). were screened out by the policy annually Child non-citizens were more likely to become uninsured afterwards, while adult non-citizens appeared to shift from Medicaid to other coverage Overall, the citizenship documentation requirement reduced Medicaid participation among non-citizens in an appropriately targeted way Nonetheless. a cost-benefit analysis indicates that the policy was a net loss to society of $600 million, through increased state administrative spending and compliance costs imposed on U S citizens applying for Medicaid (C) 2009 Elsevier B.V. All rights reserved