Enhanced citizenship verification and children's medicaid coverage

Marton, James and Snyder, Angela and Zhou, Mei (2015): Enhanced citizenship verification and children's medicaid coverage.

Abstract

This paper examines the impact of Deficit Reduction Act of 2005 mandated citizenship verification requirements on the Medicaid coverage of children using state administrative data from Georgia. Our analysis focuses on children enrolled in Medicaid prior to the reform in the eligibility category for which the reform is most likely to be binding. We find that these children were slightly more likely to exit during the first "high impact" recertification in which the enhanced citizenship verification was binding than children whose first recertification occurred just prior to the reform. In addition, we observe a slightly lower re-entry probability among children exiting during a "high impact" first recertification. Assuming at least some of the exiting children are non-citizens, the fact that the exit and re-entry rates associated with a “high impact” first recertification are only modestly different from other first recertification months suggests that the reform is probably not having a dramatic impact on citizens.

• Item Type: MPRA Paper
• Language: English
• Keywords: Medicaid; Child Health; Income Verification
• Subjects: I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy ; Regulation ; Public Health; I - Health, Education, and Welfare > I3 - Welfare, Well-Being, and Poverty > I38 - Government Policy ; Provision and Effects of Welfare Programs; J - Labor and Demographic Economics > J1 - Demographic Economics > J13 - Fertility ; Family Planning ; Child Care ; Children ; Youth

References

Angus, L and J DeVoe (2010). Evidence That The Citizenship Mandate Curtailed Participation In Oregon’s Medicaid Family Planning Program. Health Affairs 29 (4): 690-698.

Bansak, C and S Raphael (2007). The Effects of State Policy Design Features on Take-Up and Crowd-Out Rates for the State Children's Health Insurance Program. Journal of Policy Analysis and Management 26 (1):149-175.

Boylston Herndon, J, Vogel, WB, Bucciarelli, RL, and EA Shenkman (2008). The Effect of Renewal Policy Changes on SCHIP Disenrollment. Health Services Research 43(6): 2086-2105.

Bronchetti, ET (2014). Public Insurance Expansions and the Health of Immigrant and Native Children. Journal of Public Economics 120:205-219.

Dague, L (2014). The Effect of Medicaid Premiums on Enrollment: A Regression Discontinuity Approach. Journal of Health Economics (37): 1-12.

Kenney, G, Allison, RA, Costich, JF, Marton, J, and J McFeeters (2006). Effects of Premium Increases on Enrollment in SCHIP: Findings from Three States. Inquiry 43(4): 378-392.

Kenney, G., Marton, J, Costich, J, and J McFeeters (2007). Assessing the Potential Enrollment and Budgetary Effects of SCHIP Premiums: Findings from Arizona and Kentucky. Health Services Research 42 (6p2): 2354–2372.

Ketsche, P, Adams, EK, Snyder, A, Zhou, M, Minyard, K, and R Kellenberg (2007a). Discontinuity of Coverage for Medicaid and S-CHIP Children at a Transitional Birthday. Health Services Research 42 (6p2): 2410–2423.

Ketsche, P, Adams, EK, Minyard, K, and R Kellenberg (2007b). The Stigma of Public Programs: Does Separate SCHIP Program Reduce It? Journal of Policy Analysis and Management 26(4): 775-790.

Klevin, JK and W Kopczuk (2011). Transfer Program Complexity and the Take-Up of Social Benefits. American Economic Journal: Economic Policy 3: 54-90.

Marton, J (2007). The Impact of the Introduction of Premiums into a SCHIP Program. Journal of Policy Analysis and Management 26(2): 237-255.

Marton, J, Ketsche, K, Snyder, A, Adams, EK, and M Zhou (2015). Estimating Premium Sensitivity for Public Health Insurance Coverage: Selection but No Death Spiral. Forthcoming in Health Services Research.

Marton, J, Ketsche, P, and M Zhou (2010). SCHIP Premiums, Enrollment, and Expenditures: A Two State, Competing Risk Analysis. Health Economics 19(7): 772-791.

Marton, J, Yelowitz, A, and J Talbert (2014). A Tale of Two Cities? The Heterogeneous Impact of Medicaid Managed Care. Journal of Health Economics 36: 47-68.

Marton, J and A Yelowitz (2015). Health Insurance Generosity and Conditional Coverage: Evidence from Medicaid Managed Care in Kentucky. Forthcoming in the Southern Economic Journal.

Passel, JS, Capps, R, and M Fix (2004). Undocumented Immigrants: Facts and Figures. Urban Institute. Available from: http://www.urban.org/UploadedPDF/ACF506B.pdf

Ross, DC. (2007). Medicaid Documentation Requirement Disproportionately Harms Non-Hispanics, New State Data Show: Rule Mostly Hurts U.S. Citizen Children, Not Undocumented Immigrants. Center on Budget and Policy Priorities.

Ross, DC and L Cox (2007). Resuming the Path to Health Coverage for Children and Families in Medicaid and SCHP: State Efforts Face New Hurdles. Kaiser Family Foundation. Menlo Park, CA.

Sommers, BD (2010). Targeting in Medicaid: The Costs and Enrollment Effects of Medicaid’s Citizenship Documentation Requirement. Journal of Public Economics 94: 174-182.

Summer, L (2009). Getting and Keeping Coverage: States’ Experience with Citizenship Documentation Rules. (New York, The Commonwealth Fund, January 2009)

U.S. Department of Health and Human Services, Office of Inspector General. Self-declaration of U.S. citizenship for Medicaid [Internet]. Washington (DC): OIG; 2005 Jul [cited 2010 Apr 12]. Available from: http://oig.hhs.gov/oei/reports/oei-02-02-00190.pdf

U.S. Government Accountability Office. States Reported that Citizenship Documentation Requirement Resulted in Enrollment Declines for Eligible Citizens and Posed Administrative Burdens [Internet]. Washington (DC): GAO; 2007 Jun [cited 2010 Apr 12]. Available from: http://www.gao.gov/cgi-bin/getrpt?GAO-07-889

Watson, T (2014). Inside the Refrigerator: Immigration Enforcement and Chilling Effects in Medicaid Participation. American Economic Journal: Economic Policy 6(3): 313-338.

Wolfe, B and S Scrivner (2005). The Devil May Be in the Details: How the Characteristics of SCHIP Programs Affect Take-Up. Journal of Policy Analysis and Management 24(3): 499-522.