Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-22T19:04:57.098Z Has data issue: false hasContentIssue false
  • English
  • Français

Does Medicaid expansion influence county health spending? A case of New York counties

Published online by Cambridge University Press:  05 October 2021

Shihyun Noh Open the ORCID record for Shihyun Noh [Opens in a new window]  and
Ji-Hyung Park Open the ORCID record for Ji-Hyung Park [Opens in a new window]
Shihyun Noh
Affiliation:
Department of Public Administration, SUNY College at Brockport, Rochester, USA
Ji-Hyung Park*
Affiliation:
Department of Public Administration, Soongsil University, Dongjak-gu, South Korea
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

We investigated the impacts of Medicaid expansion on New York county total health spending and specifics of health spending, including health services, public health facilities and public health administration. Little research considered the financial effect of Medicaid expansion on local governments while well reported are its influences on uninsured rates and health services utilization. New York counties have contributed to health in their boundaries by providing or funding public health services, and supporting a part of the non-federal share of Medicaid expenditures and uncompensated care. Medicaid expansion can reduce the size of county expenditures for health by enrolling more previously uninsured population in the program and offering more generous federal funding for the expanded Medicaid. We offer empirical evidence that Medicaid expansion was associated with reduced county health spending.

Keywords

Health spendinglocal governmentMedicaid expansion
Type
Article
Information
Health Economics, Policy and Law , Volume 17 , Issue 3 , July 2022 , pp. 332 - 347
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arellano, M and Bond, S (1991) Some tests of specification for panel data: Monte Carlo evidence and an application to employment equations. The Review of Economic Studies 58, 277–297.CrossRefGoogle Scholar
Association of State and Territorial Health Officers (2014) Budget cuts continue to affect the health of America. Available at https://www.astho.org/budget-cuts-Sept-2014/.Google Scholar
Barlow, R (1977) Measuring the fiscal effects of revenue sharing through analysis of budget data. In Juster, FT (ed.), The Economic and Political Impact of General Revenue Sharing. Ann Arbor: Survey Research Center, Institute for Social Research, University of Michigan, pp. 81–103.Google Scholar
Bradley, EH, Canavan, M, Rogan, E, Talbert-Slagle, K, Ndumele, C, Taylor, L and Curry, LA (2016) Variation in health outcomes: the role of spending on social services, public health, and health care, 2000–09. Health Affairs 35, 760–768.CrossRefGoogle ScholarPubMed
Congressional Budget Office (CBO) (2013) Federal Grants to State and Local Governments. Washington, DC: Congressional Budget Office.Google Scholar
Department of Health and Human Services (HHS) (2013) HHS Finalizes Rule Guaranteeing 100 Percent Funding for New Medicaid Beneficiaries. Retrieved from https://www.cms.gov/newsroom/press-releases/hhs-finalizes-rule-guaranteeing-100-percent-funding-new-medicaid-beneficiaries.Google Scholar
Grady, A, Bachrach, D and Boozang, P (2017) Medicaid's Role in the Delivery and Payment of Substance Use Disorder Services in Montana (Manatt Health, March 2017).Google Scholar
Hammond, B (2018) Shifting Shares: The Costly Challenge of a State Medicaid Takeover. Retrieved from https://www.empirecenter.org/publications/shifting-shares/.Google Scholar
Hammond, B (2020) Counties’ Medicaid Role Dwindles. Retrieved from https://www.empirecenter.org/publications/shifting-shares/.Google Scholar
Kaiser Family Foundation (KFF) (2013) Uncompensated Care for Uninsured. Retrieved from https://www.kff.org/uninsured/report/uncompensated-care-for-the-uninsured-in-2013-a-detailed-examination/.Google Scholar
Kaiser Family Foundation (KFF) (2019) The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review. Retrieved from http://files.kff.org/attachment/Issue-brief-The-Effects-of-Medicaid-Expansion-under-the-ACA-Findings-from-a-Literature-Review.Google Scholar
Kaiser Family Foundation (KFF) (2020a) Total Medicaid Spending. Retrieved from https://www.kff.org/medicaid/state-indicator/total-medicaid-spending/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.Google Scholar
Kaiser Family Foundation (KFF) (2020b) Medicaid Expansion Enrollment. Retrieved from https://www.kff.org/health-reform/state-indicator/medicaid-expansion-enrollment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Expansion%20Group%20Enrollment%22,%22sort%22:%22desc%22%7D.Google Scholar
Krisberg, K (2020) Already-strained US public health workforce grapples with COVID-19: despite resource gaps, workers fight on. The Nation's Health 50, 1–12.Google Scholar
Leider, JP, Alfonso, N, Resnick, B, Brady, E, Mac McCullough, J and Bishai, D (2018) Assessing the value of 40 years of local public expenditures on health. Health Affairs 37, 560–569.CrossRefGoogle ScholarPubMed
Lobao, L and Kraybill, DS (2005) The emerging roles of county governments in metropolitan and nonmetropolitan areas: findings from a national survey. Economic Development Quarterly 19, 245–259.CrossRefGoogle Scholar
Lobao, L, Wilner Jeanty, P, Partridge, M and Kraybill, D (2012) Poverty and place across the United States: do county governments matter to the distribution of economic disparities? International Regional Science Review 35, 158–187.CrossRefGoogle Scholar
Maclean, JC and Saloner, B (2019) The effect of public insurance expansions on substance use disorder treatment: evidence from the affordable care act. Journal of Policy Analysis and Management 38, 366–393.CrossRefGoogle ScholarPubMed
Mays, GP, Smith, SA, Ingram, RC, Racster, LJ, Lamberth, CD and Lovely, ES (2009) Public health delivery systems: evidence, uncertainty, and emerging research needs. American Journal of Preventive Medicine 36, 256–265.CrossRefGoogle ScholarPubMed
McKinley, J and Ferré-Sadurní, L (2020) How to fix a $6.1 billion budget hole? Attack health care spending. New York Times. Available at https://www.nytimes.com/2020/01/21/nyregion/medicaid-budget-ny-cuomo.html.Google Scholar
Medicaid and CHIP Payment and Access Commission (MACPAC) (2017) Trends in Medicaid spending. Retrieved from https://www.macpac.gov/wp-content/uploads/2016/06/Trends-in-Medicaid-Spending.pdf.Google Scholar
Medicaid and CHIP Payment and Access Commission (MACPAC) (2019) Medicaid Expansion to the New Adult Group. Retrieved from https://www.macpac.gov/subtopic/medicaid-expansion/.Google Scholar
Meyer, A-M, Davis, M and Mays, GP (2012) Defining organizational capacity for public health services and systems research. Journal of Public Health Management and Practice 18, 535–544.CrossRefGoogle ScholarPubMed
Mofidi, SM and Jou, KK (2011) Improving the service quality, sustainability, and efficiency of mass public transportation systems. International Journal of Academic Research 3, 206–209.Google Scholar
National Association of Counties (2020) Medicaid and counties: Understanding the program and why it matters to counties. Retrieved from https://www.naco.org/sites/default/files/documents/Medicaid%20101%20final.pdf.Google Scholar
Oates, WE (1972) Fiscal Federalism. New York: Harcourt Brace Jovanovich.Google Scholar
Oates, WE (1999) An essay on fiscal federalism. Journal of Economic Literature 37, 1120–1149.CrossRefGoogle Scholar
Ostrom, V and Ostrom, E (1971) Public choice: a different approach to the study of public administration. Public Administration Review 31, 203–216.CrossRefGoogle Scholar
Park, JH (2013) Local government reform: is it effective on debt burdens? Public Finance and Management 13, 195–214.Google Scholar
Park, JH, Park, S and Maher, C (2018) The effects of Tax and Expenditure Limitations (TELs) on municipal fiscal outcomes during a period of fiscal distress. Public Finance & Management 18, 84–110.Google Scholar
Singh, SR (2014) Public health spending and population health: a systematic review. American Journal of Preventive Medicine 47, 634–640.CrossRefGoogle ScholarPubMed
Sommers, BD and Gruber, J (2017) Federal funding insulated state budgets from increased spending related to Medicaid expansion. Health Affairs 36, 938–944.CrossRefGoogle ScholarPubMed
Tiebout, CM (1956) A pure theory of local expenditures. Journal of Political Economy 64, 416–424.CrossRefGoogle Scholar
Turnbull, GK (1998) The overspending and flypaper effects of fiscal illusion: theory and empirical evidence. Journal of Urban Economics 44, 1–26.CrossRefGoogle Scholar
U.S. Government Accountability Office (GAO) (2014) States’ increased reliance on funds from health care providers and local governments warrants improved CMS data collection. Available at https://www.gao.gov/assets/670/665077.pdf.Google Scholar
US Government Accountability Office (GAO) (2012) Grants to State and Local Governments: An Overview of Federal Funding Levels and Selected Challenges. Washington, DC: GAO.Google Scholar