The Effects of Medicaid Expansion on the Racial/Ethnic Composition within Nursing Home Residents
Published in SSRN, 2022
Recommended citation: Loaiza, F. (2022). "The Effects of Medicaid Expansion on the Racial/Ethnic Composition within Nursing Home Residents" .
Abstract
The Affordable Care Act (ACA), enacted in 2010 is an essential milestone for improving the health care coverage of American citizens. This article explores the effects of the Medicaid expansion under the Affordable Care Act on the admissions of nursing home residents of racial/ethnic minorities in the US. To address this, I implement a difference-in-difference estimation methodology that accounts for multiple time periods and variations in treatment timing. The results, obtained by using aggregate data at the U.S. County level from 2000 to 2019, indicate that the racial and ethnic composition of nursing home residents is not showing improved representation of minorities; instead, it is becoming more homogeneous. This means a decline in Black residents coupled with a rise in White residents in nursing homes after the Medicaid expansion. Additionally, the study reveals variations in these trends when categorizing states by Medicaid expansion status, income inequality, and poverty rate levels. Lastly, potential mechanisms driving these results are explored and discussed.