A recent working paper titled "Spillovers in Public Benefit Enrollment: How does Expanding Public Health Insurance for Working-Age Adults affect Future Health Insurance Choices?" examines the influence of early access to publicly subsidized health insurance on later public benefit choices at Medicare eligibility. Authored by M. Kate Bundorf, Melissa McInerney, Kosali I. Simon, and Ruth Winecoff, the study uses administrative data to explore several Medicare enrollment options.
The researchers focused on individuals residing in low-income zip codes and discovered a significant increase in dual Medicaid enrollment among new Medicare beneficiaries in states that expanded Medicaid compared to those that did not. This increase was accompanied by higher healthcare usage and reduced out-of-pocket expenses. The study also noted a corresponding rise in participation in Low Income Subsidy (LIS) and Part D programs due to automatic enrollment linked with dual Medicaid coverage.
"Our results suggest that experience with Medicaid before age 65 causes meaningful behavioral responses among the lowest-income beneficiaries when they age into Medicare," the authors stated. However, their findings on Medicare Advantage enrollment remained inconclusive.
The paper underscores the importance of considering longitudinal spillovers present in other public programs with age-based eligibility criteria, such as Supplemental Nutrition Assistance Program (SNAP) and Supplemental Security Income (SSI).
For further details, readers can refer to the full working paper published by the National Bureau of Economic Research in July 2024.
Bundorf, M. Kate, Melissa McInerney, Kosali I. Simon & Ruth Winecoff. 2024.Spillovers in Public Benefit Enrollment: How does Expanding Public Health Insurance for Working-Age Adults affect Future Health Insurance Choices? Working Paper 32675. National Bureau of Economic Research, July 2024.
https://www.nber.org/papers/w32675
