Medicaid Access During Economic Distress: Lessons Learned From the Great Recession

Abstract

Medicaid enrollment increases during economic downturns which imply households using the public health insurance program during coverage gaps due to job loss. However, we provide new evidence demonstrating that the Medicaid program’s countercyclical protections against economic downturns are largely concentrated in states with more generous Medicaid eligibility criteria for adults. We exploit the timing of the 2007-2009 Great Recession to compare trends in recession-linked Medicaid enrollment between states with more generous Medicaid eligibility guidelines and states with more restrictive guidelines. For similar effects of the recession, Medicaid enrollment grew larger states in with more generous Medicaid programs. Our work suggests for every 100 people becoming unemployed in states with a restrictive Medicaid program, about 96 would be uninsured, and about 11 would enroll in Medicaid. Conversely, about 49 would be uninsured in a state with more generous Medicaid guidelines and 57 would enroll in Medicaid.

Oral Health and COVID-19: Increasing the Need for Prevention and Access

“…Only 19 states have "extensive" Medicaid dental benefits for adults (46). Among US adults aged 19 to 64, only 7.4% have Medicaid dental benefits and, alarmingly, 33.6% have no dental insurance benefits (47). The fiscal solvency of dental safety-net clinics will thus remain critical to serving at-risk populations during and after the pandemic.…”

Did Medicaid slow declines in access to health care during the great recession?

“…Prior research suggests a small uptake in recession-linked Medicaid enrollment among childless adults was concentrated within states with more generous Medicaid guidelines affecting eligibility. 12 For example, if states adopted such provisions as those indicated in Table 1, then the variable is "switched on" (ie, equals one) for the years when the law is in effect. However, the variable is "switched off" (ie, equals zero) for all years if states never adopt provisions or until states adopt Medicaid eligibility guidelines for childless adults.…”

“…This study builds on existing studies of how state Medicaid policies may moderate the dynamics between job loss and coverage status. 12,26,34 States whose Medicaid programs were more readily able to absorb (ie, due to more expansive eligibility criteria) individuals and families affected by economic downturns or mass layoffs from a large firm closure showed lower rates of unmet medical need due to financial constraints. Our results suggest more research is warranted to understand Medicaid's potential role as an insurer for households temporarily affected by job loss.…”

“…Counties within the same MSA may respond similarly to common shocks, such as rising unemployment. Counties occupying the same MSA but on different sides of a state border would be exposed to different comparative access to Medicaid 12. Baseline means of outcomes and demographic characteristics by Generosity of Medicaid Eligibility Guidelines…”

African American Unemployment and the Disparity in Periviable Births

“…First, a rising rate implies a contracting labor market that stresses not just workers, but their families and social networks as well [32][33][34]. Rising unemployment also signals decreased coping resources, including income, among the unemployed and underemployed [35]. It also engenders anxiety via fear of job loss in the remainder of the labor force [36].…”