Examining Work Requirements for Public Health Insurance

• In Event: New Methodologies for Distributional Weighting and Program Evaluation

Abstract

In June of 2018, Arkansas became the first state in U.S. history to enact work requirements for Medicaid. This policy was enforced until it was paused by a federal judge in March 2019 and subsequently struck down in July 2019 due to concerns of its unconstitutionality. The present study formulates a synthetic triple difference-in-differences framework and data from the Transformed Medicaid Statistical Information System, Current Population Survey, and National Vital Statistics System to evaluate the effects of Medicaid work requirements on monthly Medicaid enrollment, labor supply, and mortality. I find immediate decreases in Medicaid enrollment rates, persisting until the mandate was paused in March of 2019 by a federal judge. Estimated magnitudes are larger than those previously reported in official reports, suggesting potential direct and indirect effects of Medicaid work requirements on enrollment. I report no discernable changes in labor supply or mortality. The finite-sample performance of a modified placebo variance estimator tailored for triple difference-in-differences designs is also explored through a series of Monte Carlo experiments. 

Author

• Yuji Mizushima, RAND School of Public Policy
  Presenting Author