VI. Key Issues: Financing and Delivery >> D.  Health Insurance Coverage >> Public Health Insurance >> Medicaid (last updated 12.1.17)

Key Questions

What is the Impact of Medicaid on Health Outcomes?

What is the Impact of Medicaid on Non-health Outcomes?

How Much Does Medicaid Crowd Out Private Coverage?

  • Cutler, D.M. and J. Gruber, Does Public Insurance Crowd Out Private Insurance? The Quarterly Journal of Economics 111, no. 2 (1996):391–430. Estimates that every extra $1 spent on Medicaid reduces private health insurance by 50-75¢.
  • Duchovny, N. and L. Nelson. The State Children’s Health Insurance Program, CBO Pub no. 2970 (Washington,DC: Congressional Budget Office, 2007). This report projects a crowd-out rate of 25% to 50% for SCHIP.

  • Gruber, J. and K. Simon, Crowd-Out Ten Years Later: Have Recent 

    Public Insurance Expansions Crowded Out Private Heath Insurance? Working Paper no. 12858 (Cambridge: National Bureau of Economic Research, 2007). E

    stimates SCHIP crowd-out at 60%.

Is Medicaid a “Welfare Magnet”?

  • Schwartz, Aaron L., and Benjamin D. Sommers. Moving for Medicaid? Recent Eligibility Expansions Did Not Induce Migration from Other States. Health Affairs 33, no. 1 (January 1, 2014 2014): 88-94. We used data from the Current Population Survey to examine the migration patterns of low-income people before and after recent expansions of public insurance in Arizona, Maine, Massachusetts, and New York. Using difference-in-differences analysis of migration in expansion and control states, we found no evidence of significant migration effects. Our preferred estimate was precise enough to rule out net migration effects of larger than 1,600 people per year in an expansion state. These results suggest that migration will not be a common way for people to obtain Medicaid coverage under the current expansion and that interstate migration is not likely to be a significant source of costs for states choosing to expand their programs.


Medicaid Financing

Medicaid Provider Taxes




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