Replacing Medicaid with an Imperfect Substitute: Implications for Health Inequality
A 2015 policy change substantially increased the administrative burden involved in accessing health insurance for Pacific Islander immigrants in Hawaii. We examine the heterogeneous health-care use effects of this policy, which revoked Medicaid eligibility for these migrants and replaced it with acc...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Russell Sage Foundation
2023-09-01
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| Series: | RSF: The Russell Sage Foundation Journal of the Social Sciences |
| Subjects: |
| _version_ | 1827863131079049216 |
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| author | Randall Q. Akee Timothy J. Halliday Teresa Molina |
| author_facet | Randall Q. Akee Timothy J. Halliday Teresa Molina |
| author_sort | Randall Q. Akee |
| collection | DOAJ |
| description | A 2015 policy change substantially increased the administrative burden involved in accessing health insurance for Pacific Islander immigrants in Hawaii. We examine the heterogeneous health-care use effects of this policy, which revoked Medicaid eligibility for these migrants and replaced it with access to subsidized private health insurance. Using data on the universe of hospitalizations and emergency room visits in Hawaii, we classify individuals as high or low risk based on their use in a baseline period. We then use a difference-in-differences strategy to estimate the effects of the policy on use, separately for low-risk and high-risk groups. The policy exacerbated health inequality: high-risk individuals experienced larger reductions in total use and larger increases in uninsured use. |
| first_indexed | 2024-03-12T14:04:32Z |
| format | Article |
| id | doaj.art-2c3c8e607e9c467984a919568386a7c2 |
| institution | Directory Open Access Journal |
| issn | 2377-8253 2377-8261 |
| language | English |
| last_indexed | 2024-03-12T14:04:32Z |
| publishDate | 2023-09-01 |
| publisher | Russell Sage Foundation |
| record_format | Article |
| series | RSF: The Russell Sage Foundation Journal of the Social Sciences |
| spelling | doaj.art-2c3c8e607e9c467984a919568386a7c22023-08-21T14:58:28ZengRussell Sage FoundationRSF: The Russell Sage Foundation Journal of the Social Sciences2377-82532377-82612023-09-01946183https://doi.org/10.7758/RSF.2023.9.4.03Replacing Medicaid with an Imperfect Substitute: Implications for Health InequalityRandall Q. Akee0Timothy J. Halliday1Teresa Molina2https://orcid.org/0000-0003-3829-0042University of California at Los AngelesUniversity of Hawai‘i at ManoaUniversity of Hawai‘i at ManoaA 2015 policy change substantially increased the administrative burden involved in accessing health insurance for Pacific Islander immigrants in Hawaii. We examine the heterogeneous health-care use effects of this policy, which revoked Medicaid eligibility for these migrants and replaced it with access to subsidized private health insurance. Using data on the universe of hospitalizations and emergency room visits in Hawaii, we classify individuals as high or low risk based on their use in a baseline period. We then use a difference-in-differences strategy to estimate the effects of the policy on use, separately for low-risk and high-risk groups. The policy exacerbated health inequality: high-risk individuals experienced larger reductions in total use and larger increases in uninsured use.cost sharinghealth insuranceinsurance exchangemedicaid |
| spellingShingle | Randall Q. Akee Timothy J. Halliday Teresa Molina Replacing Medicaid with an Imperfect Substitute: Implications for Health Inequality RSF: The Russell Sage Foundation Journal of the Social Sciences cost sharing health insurance insurance exchange medicaid |
| title | Replacing Medicaid with an Imperfect Substitute: Implications for Health Inequality |
| title_full | Replacing Medicaid with an Imperfect Substitute: Implications for Health Inequality |
| title_fullStr | Replacing Medicaid with an Imperfect Substitute: Implications for Health Inequality |
| title_full_unstemmed | Replacing Medicaid with an Imperfect Substitute: Implications for Health Inequality |
| title_short | Replacing Medicaid with an Imperfect Substitute: Implications for Health Inequality |
| title_sort | replacing medicaid with an imperfect substitute implications for health inequality |
| topic | cost sharing health insurance insurance exchange medicaid |
| work_keys_str_mv | AT randallqakee replacingmedicaidwithanimperfectsubstituteimplicationsforhealthinequality AT timothyjhalliday replacingmedicaidwithanimperfectsubstituteimplicationsforhealthinequality AT teresamolina replacingmedicaidwithanimperfectsubstituteimplicationsforhealthinequality |