RSF grantees Sanders Korenman (Baruch College, City University of New York), Dahlia Remler (Baruch College, City University of New York), and Rosemary Hyson (Baruch College, City University of New York) recently published an article in the Social Service Review, “Medicaid Expansions and Poverty: Comparing Supplemental and Health-Inclusive Poverty Measures.” This article builds on Korenman and Remler’s RSF-supported research to assess the impact of the passage of the Affordable Care Act on poverty reduction by developing a health-inclusive poverty measure (HIPM). RSF recently supported Korenman and Remler’s ongoing work in this area with a presidential authority grant.
In this article, Korenman, Remler, and Hyson explore how the health-inclusive poverty measure that they developed more effectively gauges the ways that the provision of health insurance can help to reduce poverty. Developed in the wake of the passage of the ACA and the subsequent decisions by select states to expand Medicaid, the health-inclusive poverty measure aims to better capture how the provision of non-cash health insurance benefits can positively impact the financial prospects of the poor. The authors outline how Medicaid expansion supports families in need by reducing the amount they spend on out-of-pocket medical costs, thereby freeing up those resources for other expenses, and promoting the health of both child and adult recipients. The new HIPM treats health insurance as a basic need, like food and shelter, and allows policy analysts to assess how the provision of health insurance benefits directly effects poverty. The figure below illustrates the differences between how the official poverty measure, supplemental poverty measure, and health-inclusive poverty measure each calculate family resources and expenses.
The results from this research point to the efficiency of Medicaid expansion in poverty reduction, and indicate that health-inclusive poverty and deep poverty rates are significantly lower in states that expanded the program versus those that had not. The authors outline how changes in health care policy, such as increases in health insurance premiums, eroding the quality of coverage available through the most affordable plans, and policies that restrict individuals’ ability to purchase health insurance, threaten the poverty reducing effects of Medicaid expansion and the availability of health insurance through the ACA. They also acknowledge imminent threats to repeal and undermine the Affordable Care Act and Medicaid expansion at the federal and state levels.