Would the U.S. Population Look Different had States Decided Not to Offer Medicaid?

• In Event: 599 - Section on Sociology of Population Paper Session. Economic Inequality and Population Health

Abstract

Research shows that increased access to health insurance leads to higher utilization of care. However, it is unclear if it translates into improved health and lower mortality. This paper contributes to this debate by examining the relationship between health insurance and health at the population-level. I use state variation in the timing of Medicaid implementation after Title XIX in 1965 to explore its role in improvements to population health. State fixed effect models reveal that the rate of decline in a state’s infant mortality rate (IMR) and survival probability into adulthood (20p0) increases after the state’s adoption of Medicaid. The average annual decline in both IMR and 20p0 increased by approximately 50 percent after Medicaid implementation compared to the rate of decline before Medicaid. I corroborate these findings by establishing an association between state Medicaid implementation and a more favorable under-20 mortality profile parameterized by period-standardized Brass Logit Relational models.

Author

• Heeju Sohn, University of Pennsylvania