• July 27, 2015
    Medicaid at 50: A Look at the Long-Term Benefits of Childhood Medicaid

  • An emerging body of research underscores the significant role that Medicaid plays as a source of health coverage and financial protection for children and families—the benefits of which last through adulthood. New data highlight striking examples of the long-term effects of Medicaid—including better health, lower rates of mortality, better educational and economic outcomes, and many ways in which government recoups its investment in the long term. These findings underscore Medicaid’s role as not only a foundational source of health coverage for children, but also an investment in their future.

    In light of these findings, the need to preserve and strengthen Medicaid for future generations of children has never been greater as the program reaches its fiftieth year. This paper highlights the mounting evidence underscoring the positive long-term effects of childhood Medicaid coverage that emerge later in life for adolescents and adults.

    The Top Three Benefits

    1. As the Medicaid program turns 50 a growing body of research provides evidence that children with Medicaid coverage become healthier adults.

    Using longitudinal data from Medicaid expansions in the 1980s and 1990s, researchers found that children with access to Medicaid showed a 26 percentage point decline in the incidence of high blood pressure in adulthood. In addition, children with Medicaid had lower rates of hospitalizations and emergency room visits in adulthood—leading the government to recoup between 3 and 5 percent of the initial cost of Medicaid eligibility expansions in just one year. Children with Medicaid are also healthier adolescents, with lower rates of eating disorders, drinking, and mortality.

    2. Medicaid eligibility expansions for children also lead to greater academic achievements.

    Children who benefited from the Medicaid eligibility expansions were less likely to drop out of high school (9.7 percent decline) and more likely to graduate from college (5.5 percent increase).

    3. Children with access to Medicaid had greater economic success as adults.

    Two new studies indicate that these children had higher incomes later in life and were more likely to surpass their families’ economic status, making them less reliant on safety net programs and contributing to a strong government return on investment. Each additional year of Medicaid eligibility from birth to age 18 increased cumulative tax payments in adulthood of $186 per person (a 0.9 percent increase) and reduced receipt of the Earned Income Tax Credit receipts by $75 (a 2.4 percent decrease) by age 28. The increase in tax payments alone returned nearly one-third (32 cents on the dollar) of the initial cost of expanding childhood Medicaid by the time these children reached age 28, and 56 cents of each dollar by the time the children reached age 60. Medicaid-eligible children also had greater economic mobility, with a greater likelihood that their income exceeded that of their parents.


    Medicaid at 50

    Editorial Board,

    Published: Tuesday, April 28, 2015
    What is going on in the Florida Legislature right now is morally and fiscally indefensible and threatens the well-being of Florida and its people.

    It isn't complicated but has been made so by ideologues with power. The state has more than 800,000 people who are uninsured because they do not qualify for Medicaid or cannot afford insurance. The federal government has a contract with Florida, as with other states, to provide what is known as Low Income Pool funds to pay for hospital charity care when the poor go to an emergency room.

    As part of the Affordable Care Act, the Obama administration told states the LIP money would be going away and urged them to replace it with a Medicaid expansion plan. So far 28 states have done so. The idea is it is more efficient medically and economically to provide regular health care to the poor somewhere besides a hospital emergency room.

    The Florida Senate understood. So did Florida's major business groups, hospitals organizations and voters. A Senate Medicaid expansion plan calls for recipients to be working or in school and pay a small monthly premium. The plan, approved by Washington, would provide more care at less cost - saving an estimated $1.7 billion over five years - and create tens of thousands of jobs and pump tens of billions of dollars into Florida's economy over the next decade.

    The Florida House leadership, however, has opted to play politics. Anything tied to Obamacare is anathema. From the start, Speaker Steve Crisafulli, R-Merritt island, and his lieutenants have stubbornly refused to even discuss Medicaid expansion. At all. Meanwhile, Gov. Rick Scott, who should be providing leadership toward compromise, is only exacerbating an already horrible situation. Not only is he opposing Medicaid expansion - after he was for it - he is suing the federal government for the LIP money, a case he is almost sure to lose on our dime. Scott says he does not trust the feds to provide the Medicaid expansion money - even though it is codified in the ACA law - but instead is demanding the feds keep the LIP money flowing. His stance is weak and hurts Florida and its residents.

    But the damage does not stop there. Now the House and the Senate cannot complete a state budget - their singular constitutionally required task - by the end of the legislative session Friday. Their budgets are $4 billion apart, largely because of the health care impasse, and new funding for education, mental health care and new prison guards as well as some modest tax cuts are all at serious risk.

    All so Scott, Crisafulli and Co. can make some ideologically driven political point that ultimately hurts real people.

    Thank goodness for the adults in the Florida Senate. What Scott and the House membership are doing is endangering the health and well-being of Florida, which, contrary to the governor's economic hosannas, is still limping out of the recession.

    Giving poor people access to health care while at the same time saving the state money and boosting its economy is good public policy.

    Refusing to even discuss it is simply morally and fiscally indefensible.