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- Title
Medicaid expansion and the Medicaid undercount in the American Community Survey.
- Authors
Boudreaux, Michel; Noon, James M.; Fried, Brett; Pascale, Joanne
- Abstract
<bold>Objective: </bold>To measure discordance between aggregate estimates of means-tested coverage from the American Community Survey (ACS) and administrative counts and examine the association of discordance with ACA Medicaid expansion.<bold>Data Sources: </bold>2010-2016 ACS and counts of Medicaid and Children's Health Insurance Program enrollment from the Centers for Medicare & Medicaid Services.<bold>Study Design: </bold>State-by-year counts of means-tested coverage from the ACS were compared to administrative counts using percentage differences. Discordance was compared for states that did and did not adopt expansion using difference-in-differences. We then contrasted the effect of expansion on means-tested coverage estimated from the ACS with results from administrative data.<bold>Data Collection/extraction: </bold>Survey and administrative data.<bold>Principal Findings: </bold>One year before expansion there was a 0.8 and 4 percent overcount in expansion and nonexpansion states, respectively. By 2016, there was a 10.64 percent undercount in expansion states vs a 0.02 percent undercount in nonexpansion states. The ACS suggests that expansion increased means-tested coverage in the full population by three percentage points, relative to five percentage points suggested by administrative records.<bold>Conclusions: </bold>Discordance between the ACS and administrative records has increased over time. The ACS underestimates the impact of Medicaid expansion, relative to administrative counts.
- Subjects
AMERICAN Community Survey; CHILD health insurance; MEDICAID
- Publication
Health Services Research, 2019, Vol 54, Issue 6, p1263
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.13213