Who Receives Medicaid in Old Age? Rules and Reality

Margherita Borella, Mariacristina De Nardi, Eric French

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Medicaid is a government programme that also provides health insurance to the elderly who have few assets and either low income or catastrophic health care expenses. We ask how the Medicaid rules map into the reality of Medicaid recipiency, and we ask what other observable characteristics are important to determine who ends up on Medicaid. The data show that both singles and couples with high retirement income can end up on Medicaid at very advanced ages. We find that, conditioning on a large number of observable characteristics, including those that directly relate to Medicaid eligibility criteria, single women are more likely to end up on Medicaid – so are non-white people, but, surprisingly, their higher recipiency is concentrated in the higher income percentiles. We also find that people with low incomes who have a high-school diploma or higher degree are much less likely to end up receiving Medicaid than their less-educated counterparts. All of these effects are large and depend on retirement income in a very non-linear way.

Original languageEnglish (US)
Pages (from-to)65-93
Number of pages29
JournalFiscal Studies
Issue number1
StatePublished - Mar 2018
Externally publishedYes

Bibliographical note

Funding Information:
We thank Marco Bassetto, Amy Finkelstein, John Jones, Helen Koshy, Lee Lockwood, James Ziliak, and two anonymous referees for helpful comments and suggestions. M. De Nardi gratefully acknowledges support from the European Research Council (ERC), grant 614328 ‘Savings and Risks’. E. French gratefully acknowledges support from the Michigan Retirement Research Center (MRRC). The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research, the Centre for Economic Policy Research (CEPR), any agency of the federal government, the Federal Reserve Bank of Chicago or the Institute for Fiscal Studies (IFS). Keywords: Medicaid, elderly, permanent income. JEL classification numbers: H51, I13, I14.

Publisher Copyright:
© 2017 The Authors. Fiscal Studies published by John Wiley & Sons Ltd. on behalf of Institute for Fiscal Studies


  • H51
  • I13
  • I14
  • Medicaid
  • elderly
  • permanent income


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