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A new study co-authored by a Texas A&M University faculty-researcher analyzes why insurance exchange and Medicaid enrollment varies dramatically from state to state, controlling for the size of each state’s uninsured population prior to the enactment of the Affordable Care Act in 2010. The researchers found that insurance exchange and Medicaid enrollment rates were each highly correlated with state unemployment rates.
The study, published recently in the Journal of Health Politics, Policy and Law, and co-authored by Timothy Callaghan, an assistant professor in the Department of Health Policy and Management at the School of Public Health, examines these variations to determine their causes and what they mean.
“Texas enrolling a million people doesn’t mean much in a comparative context if there are still almost five million uninsured,” Callaghan said. With these adjusted enrollment figures, the researchers calculated the effects of four factors on enrollment under the act: partisanship, economic measures (such as affluence and unemployment rates), state administrative capacity and the percentage of the state that voted for President Obama in the 2012 election.
Insurance exchanges saw a negative effect from high unemployment, which Callaghan said is hardly surprising, as insurance involves an extra cost that unemployed people might not be willing to take on.
Unemployment had the opposite effect on Medicaid, with states with higher unemployment rates seeing higher Medicaid enrollment rates. This effect was much more noticeable in states that expanded their Medicaid programs.
More at the School of Public Health