NBER

Zeynal Karaca

Agency for Healthcare Research and Quality
5600 Fishers Lane
Rockville, MD 20857
USA

E-Mail: EmailAddress: hidden: you can email any NBER-related person as first underscore last at nber dot org
Institutional Affiliation: AHRQ

NBER Working Papers and Publications

September 2019All Medicaid Expansions Are Not Created Equal: The Geography and Targeting of the Affordable Care Act
with Craig Garthwaite, John A. Graves, Tal Gross, Victoria R. Marone, Matthew J. Notowidigdo: w26289
We use comprehensive patient-level discharge data to study the effect of Medicaid on the use of hospital services. Our analysis relies on cross-state variation in the Affordable Care Act’s Medicaid expansion, along with within-state variation across ZIP Codes in exposure to the expansion. We find that the Medicaid expansion increased Medicaid visits and decreased uninsured visits. The net effect is positive for all visits, suggesting that those who gain coverage through Medicaid consume more hospital services than they would if they remained uninsured. The increase in emergency department visits is largely accounted for by “deferrable” medical conditions. Those who gained coverage under the Medicaid expansion appear to be those who had relatively high need for hospital services, suggesting...

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