Household finances
Financial protection is one of the most consistent findings: fewer catastrophic bills and less medical debt.
Catastrophic medical bills nearly eliminated Strong design
In Oregon's randomized lottery, out-of-pocket spending above 30% of income fell by 4.48 percentage points, a reduction of more than 80%.1
Less medical debt in collections Strong design
Medicaid coverage lowered the chance of having medical bills in collections by 6.4 percentage points (about 25%) in Oregon's first year.2 Nationally, ACA expansion reduced newly reported medical collections by an estimated $5.9 billion.3
Smaller collection balances; credit scores not clearly changed Strong design
In low-income ZIP codes, expansion reduced collection balances by about $65 to $88 per person on average.4
Limits: These collections were not limited to medical bills. The same study found no significant effect on credit scores or bankruptcy.
Fewer evictions Association
Expansion was associated with about 1.15 fewer evictions per 1,000 renter households per year in California.5
Limits: One state and an observational design. Treat this as suggestive.
Sources for this page
- Baicker et al., 'The Oregon Experiment', NEJM 2013;368:1713-22, doi:10.1056/NEJMsa1212321 (2013-05-02). https://www.nejm.org/doi/full/10.1056/NEJMsa1212321 [evidence H5]
- Finkelstein et al., 'The Oregon Health Insurance Experiment: Evidence from the First Year', QJE 127(3):1057-1106 (2012). https://pmc.ncbi.nlm.nih.gov/articles/PMC3535298/ [evidence F1]
- Brevoort, Grodzicki, Hackmann, J Public Econ 187:104203, doi:10.1016/j.jpubeco.2020.104203 (2020). https://doi.org/10.1016/j.jpubeco.2020.104203 [evidence F2]
- Hu, Kaestner, Mazumder, Miller, Wong, J Public Econ 163:99-112 (2018). https://pmc.ncbi.nlm.nih.gov/articles/PMC6208351/ [evidence F3]
- Zewde, Eliason, Allen, Gross, AJPH 2019;109(10):1379-83, doi:10.2105/AJPH.2019.305230 (2019-10). https://doi.org/10.2105/ajph.2019.305230 [evidence F4]
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