Poor vs. Rich: Impact of the ACA Medicaid Expansion on Inequality in Access to Care” Victoria Perez, Indiana University Bloomington
Abstract:
By most accounts, Medicaid is the largest federal anti-poverty
program. Yet even a half-century after the enactment of Medicaid
and Medicare, socioeconomic disparities in healthcare access
remain substantial, especially for non-elderly childless adults
who have been largely unaffected by expansions of these “Great
Society” programs (Hicken, 2012). The Medicaid and Marketplace
subsidy insurance expansions of the Affordable Care Act (ACA)
have the potential to reduce these disparities. However, as a
result of the 2012 U.S. Supreme Court ruling, about half the
states did not expand their Medicaid program. I propose to
exploit this state-level variation in Medicaid expansion, using
data from the Behavioral Risk Factor Surveillance System (BRFSS),
2005-2015, to estimate the causal effect of ACA Medicaid policy
on socioeconomic disparities in access to care, and its resulting
influence on health. The results of my study are important for
ongoing state policy discussions around ACA Medicaid expansions
that have large implications for the wellbeing of low-income
Americans. I conclude with directions for further research on
Medicaid policy and poverty building on the work proposed in this
small grant application.
Victoria Perez is an assistant professor at the School of
Public and Environmental Affairs at Indiana University
Bloomington. She earned her Ph.D. in managerial science and
applied economics from the Wharton School at the University of
Pennsylvania, where her dissertation focused on the effects of
private managed care on Medicaid. She also holds a bachelor’s
degree in economics from the University of Pennsylvania.
