The long-term impacts of Medicaid exposure in early childhood: Evidence from the program's origin

Michel H. Boudreaux, Ezra Golberstein, Donna D. McAlpine

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


This paper examines the long-term impact of exposure to Medicaid in early childhood on adult health and economic status. The staggered timing of Medicaid's adoption across the states created meaningful variation in cumulative exposure to Medicaid for birth cohorts that are now in adulthood. Analyses of the Panel Study of Income Dynamics suggest exposure to Medicaid in early childhood (age 0-5) is associated with statistically significant and meaningful improvements in adult health (age 25-54), and this effect is only seen in subgroups targeted by the program. Results for economic outcomes are imprecise and we are unable to come to definitive conclusions. Using separate data we find evidence of two mechanisms that could plausibly link Medicaid's introduction to long-term outcomes: contemporaneous increases in health services utilization for children and reductions in family medical debt.

Original languageEnglish (US)
Pages (from-to)161-175
Number of pages15
JournalJournal of Health Economics
StatePublished - Jan 1 2016

Bibliographical note

Funding Information:
This project was supported by an Interdisciplinary Doctoral Fellowship from the University of Minnesota , by grant number R36HS021690 from the Agency for Healthcare Research and Quality, and by a grant to the Minnesota Population Center from the Eunice Kennedy Shriver National Institute for Child Health and Human Development ( 5R24HD041023 ). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality or any other funder. The collection of data [The Panel Study of Income Dynamics] used in this study was partly supported by the National Institutes of Health under grant number R01 HD069609 and the National Science Foundation under award number 1157698 . Portions of the paper are based on restricted use data from the National Health Interview Survey. The findings and conclusions drawn from these data are those of the authors and do not necessarily represent the views of the Research Data Center, the National Center for Health Statistics, or the Centers for Disease Control and Prevention. Doug Almond, Hillary Hoynes, Amy Finkelstein, Martha Bailey and Andrew Goodman-Bacon generously provided data from the 1960s and 1970s and guided us in their use. We are grateful to Marianne Bitler, Aaron Sojourner, David Frisvold, Martha Bailey, Bryan Dowd, and seminar participants at the Human Capital Research Collaborative, the Rethinking Barker Conference, the American Society of Health Economists Biennial Conference, the AcademyHealth Annual Research Meeting, Virginia Commonwealth University, University of Kansas, University of Maryland, George Washington University and Vanderbilt University for their helpful comments. We also thank the editor and the anonymous reviewers.

Publisher Copyright:
© 2015 Elsevier B.V.


  • Health and human capital
  • Medicaid


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