Did the Medicaid-Eligibility Expansions Increase the Reporting of Children's Health Problems? Evidence from the SIPP

Beginning around 1990, disability rates of children, as reported by their parents, began to increase. At the same time, a major expansion of Medicaid eligibility to children outside of the welfare population was taking place. Data from multiple panels of the Survey of Income and Program Participation are used to estimate the influence of the expansion policy on parental reporting of children's activity limitations and the presence of specific conditions. There is little evidence that the expansions affected reporting for the targeted group of low-income children (those who would previously have been Medicaid-ineligible). However, the expansions appear to have positive and robust effects on the likelihood that certain limitations and conditions are reported for AFDC-receiving children. Given that welfare-receiving children have had access to free medical care since 1975, these findings present a puzzle. The remainder of the paper discusses a variety of explanations for these findings. Acknowledgements: This research was funded by the Joint Center for Poverty Research's Development Grants Program for Census-Funded Research using the SIPP. I thank Farzad Mayashekhi and Dawn Owens-Nicholson of the University of Illinois for excellent assistance with the data and Lara Shore-Sheppard for providing a database of Medicaid eligibility rules. I am grateful to Arleen Leibowtiz, Brian O'Hara, and Tim Waidman for comments on a preliminary version of this paper.