Family Financial Well-Being Rose After Medicaid Expansions, Research Shows

Low-income parents who switched to Medicaid under Affordable Care Act expansions often reaped benefits that appeared to help their financial and home lives, according to a pair of recent studies co-authored by Lindsey Rose Bullinger of the School of Public Policy. 

The parents often saw lower out-of-pocket expenses for medical care and appeared to gain the flexibility to take new jobs that provided more opportunities to tend to their children’s educational needs, according to the study.  

“The cost of private health insurance for some low-income families can be prohibitive or burdensome. These studies show that if some of that burden is relieved, the lives of those families can be dramatically improved across a variety of dimensions,” Bullinger said. 

One study was published recently in INQUIRY: The Journal of Health Care Organization, Provision, and Financing. In it, Bullinger and her colleagues examined data from the 2016-2020 National Survey on Children’s Health. They found that public health insurance coverage for children rose 5.5 percentage points and private insurance enrollment fell by a similar amount in states that expanded Medicaid after 2015 as compared to those states who did not choose to broaden the eligibility pool for the government-funded insurance program for low-income people. 

That finding suggests many parents dropped their children’s more expensive private insurance for more affordable public insurance once the adults in the family became eligible for Medicaid. The data also show a marked reduction in out-of-pocket expenses for child medical care, suggesting that many families who opted for Medicaid included children with significant medical issues requiring costly treatment. 

That tracks with another finding, that many of the parents who enrolled their families in Medicaid also switched jobs after enrolling. One possibility: Parents no longer felt tied to a less flexible job because of the insurance coverage it offered and jumped to something more flexible to help them better care for their children. 

The other study, published in the Southern Economic Journal, found that children’s reading test scores improved by about 2% among children of expansion-state residents who switched to Medicaid. This suggests that the improved financial well-being provided by Medicaid enrollment made it easier for parents to spend more time reading to their children, helping with homework, or eating dinner together. 

The study found no discernible improvement in math scores or measures of socioemotional skills, the authors note. Still, they say that “taken together, (the) results suggest that the improvements in children’s reading scores may have been due to improvements in families’ functioning.” 

In another study published in 2021 in Economics and Human Biology, Bullinger, Gopalan, and Lombardi found that parents reported significantly better health after Medicaid expansion. 

Bullinger co-authored the paper in INQUIRY, titled “Better Late Than Never: Effects of Late ACA Medicaid Expansions for Parents on Family Health-Related Financial Well-Being,” with Caitlin McPherrann Lombardi of the University of Connecticut and Maithreyi Gopalan of the University of Pennsylvania. It is available at https://doi.org/10.1177/00469580221133215 

She co-wrote the article in Southern Economic Journal, “Impacts of Publicly Funded Health Insurance for Adults on Children’s Academic Achievement,” with the same co-authors. 

The School of Public Policy is a unit of the Ivan Allen College of Liberal Arts.