Associations of Expanding Parental Medicaid Eligibility and Parental Health and Family Functioning.

Abstract

OBJECTIVE\nTo examine the effects of Medicaid eligibility on parental health, parenting practices, and child development for elementary-school aged children on low-income families.\n\n\nMETHODS\nLongitudinal analysis using data from the Early Child Longitudinal Study- Kindergarten: 2011-2016. Outcomes included parental self-rated health, parental depressive symptoms, parents communication and warmth towards children, and children s social skills and externalizing and internalizing behaviors. We estimated two-way (individual and year) fixed effects models using Medicaid eligibility as a continuous variable, controlling for changing economic conditions and changes in family structure, and state-specific trends. We then estimated triple difference models comparing lower income families to those with higher incomes. Finally, we estimated difference-in-difference models and used entropy weights in order to account for differences in trends prior to 2014 for some outcomes.\n\n\nRESULTS\nIn fixed effects models, expanding Medicaid eligibility by 100 percent of the federal poverty line is associated with a 12.7 percentage point reduction in parents report of having fair or poor health (95% CI; -23.9, -1.5) and a 1.15-point improvement in a 12-point scale of parental warmth towards children (95% CI; 0.15, 2.16). Results were substantively similar in entropy-balanced difference-in-differences models. In triple difference models, expanded Medicaid eligibility by is associated with a 0.46 point improvement in warmth (95% CI, 0.10, 0.83) but not improved parental health. No significant effects for child behavior or other outcomes were detected.\n\n\nCONCLUSIONS\nExpanding Medicaid for parents may have implications for intergenerational family functioning that could lead to broader social benefits.