Public Program Enrollment Following US State Medicaid Expansion and Outreach.

Abstract

To examine the joint impact of states' Medicaid expansion and participation in Medicaid enrollment outreach at the take-up of other means-tested public programs (Women, Infants, and Children [WIC], Supplemental Nutrition Assistance Program [SNAP]). Data were used from the American Community Survey, WIC, and SNAP. We used difference-in-differences analyses to compare the combined impact of Medicaid expansion and enrollment outreach on program enrollment. Enrollment in means-tested programs decreased after 2014, regardless of Medicaid expansion and outreach status. However, gaps in enrollment among states that both expanded Medicaid and conducted outreach, compared with states that did neither, increased after expansion of SNAP and WIC enrollment (10.15% and 4.57%, respectively) and favored those states that did both. States that both expanded Medicaid and conducted Medicaid enrollment outreach experienced smaller decreases in SNAP and WIC enrollment in comparison with other states. Moreover, enrollment in SNAP has shown to reduce health care expenditures. Greater collaboration among public programs, such as streamlining eligibility data and concerted outreach efforts, is one of the achievements of the Affordable Care Act that should be continued.