Expanding medical health insurance for adults also increased coverage for kids – The Hill


Story at a look

  • A 2008 experiment conducted in Oregon showed that more eligible children are enrolled in Medicaid once adults of their household also enroll.
  • The study was conducted prior to passage of the Inexpensive Care Act, which gave states the choice to expand eligibility for Medicaid coverage.
  • Although more children were covered within the short-term due to the experiment, many remained uninsured, and enrollment dwindled over time. 

An evaluation of the 2008 Oregon Medicaid lottery revealed that after three months, for each nine adults enrolled, one additional eligible child was also enrolled in this system — underscoring the magnitude of the “woodwork effect” on insurance enrollment. 

Findings were published within the American Economic Journal. The “woodwork effect” is a term utilized by analysts to explain how individuals eligible for advantages may come “out of the woodwork” to assert certain advantages. 

The findings of the present study highlight how adult access to Medicaid can significantly boost enrollment rates for previously uncovered children. Nevertheless, authors caution many more remain outside the system. 

Medical health insurance coverage has been tied to a myriad of positive health outcomes including improved access to care, quality of life and increased survival rates for cancer patients, amongst others. 

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In 2008, the Oregon Medicaid lottery randomly chosen low-income, uninsured individuals to be allowed to use for this system, while children in these households were eligible despite any lottery end result. A complete of 90,000 applications were received for the ten,000 recent slots created by the Oregon lottery. 

Throughout the U.S., as many as 14 percent of eligible adults and seven percent of eligible children remain unenrolled in Medicaid.

Medicaid provides federally funded medical health insurance to the nation’s underserved populations while under the 2010 Inexpensive Care Act (ACA), states had the choice of Medicaid coverage eligibility to residents. As of 2022, just 12 states haven’t adopted Medicaid expansion.

Effects of the Oregon data weren’t large enough to place pressure on the state’s Medicaid system, authors explained, noting most previously unenrolled children remain uninsured. Only around 6 percent of those that might have been enrolled due to the lottery actually became insured. The proportion of kids enrolled also decreased over time.

“The magnitude of the effect is economically and practically meaningful, however the effect is fairly short-lived,” said study co-author Adam Sacarny of Columbia University in a press release. 

During ACA negotiations, some critics cautioned that the “woodwork effect” of Medicaid expansion with regard to children’s enrollment would increase the financial burden on taxpayers. Nevertheless, the present study suggests any increase was modest.

In keeping with researchers, the prices of covering children on Medicaid can also be roughly 4 times lower than that of adults.

More research is required to higher understand why more parents don’t join their eligible children for Medicaid. Nevertheless, for adults, several barriers to enrollment exist including lack of expertise on eligibility and perceived social stigma.

Published on Aug. 10, 2022


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