Saturday, January 21, 2017

Did Medicaid expansion make people move from non-expansion states to Kentucky? A study suggests it did not

When Kentucky expanded Medicaid and Tennessee and Virginia didn't, did that prompt some people to move from Tennessee and Virginia to Kentucky? A study suggests that it did not.

There is "little to no evidence" that Medicaid expansion under the Patient Protection and Affordable Care Act in 2014 encouraged migration to expansion states from non-expansion states in that year, says the author of a study published in the Journal of Policy Analysis and Management.

"Migration from non-expansion states to expansion states, among those who I classify as being potentially Medicaid-eligible, did not increase relative to migration in the reverse direction," University of Maryland Ph.D. student Lucas Goodman said in a JPAM interview about his study. He noted that the possibility of in-migration and additional taxpayer expense "were often cited by non-expanding states as a reason why they should not expand."

Goodman said he was surprised at his finding, because "Medicaid expenditures in 2014 for the newly-eligible population averaged about $5,500, which is a large amount relative to income for the typical newly-eligible individual. Yet, individuals were apparently not willing to migrate in order to gain access to these benefits."

He added, "The big question is whether migration effects will increase in the longer term, either as individuals in non-expansion states learn about the presence of the expansion in other states or states’ expansion/non-expansion decisions appear to be more set in stone." However, the reform law and Medicaid likely to undergo major changes under President Donald Trump and the Republican Congress.

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