Jacob Wallace
@jacobwswallace.bsky.social
Associate Professor @ Yale SPH and Sixers fan. Health economist whose research is focused on the Medicaid program.
RESULT 3: Work requirements led to substantial coverage losses even for those with incomes
Translation — More evidence that not only about whether folks are working, even those with incomes are screened out...
This appears to be about paperwork.
@pamherd.bsky.social @donmoyn.bsky.social
5/
Translation — More evidence that not only about whether folks are working, even those with incomes are screened out...
This appears to be about paperwork.
@pamherd.bsky.social @donmoyn.bsky.social
5/
June 2, 2025 at 2:07 PM
RESULT 3: Work requirements led to substantial coverage losses even for those with incomes
Translation — More evidence that not only about whether folks are working, even those with incomes are screened out...
This appears to be about paperwork.
@pamherd.bsky.social @donmoyn.bsky.social
5/
Translation — More evidence that not only about whether folks are working, even those with incomes are screened out...
This appears to be about paperwork.
@pamherd.bsky.social @donmoyn.bsky.social
5/
RESULT 2: Sickest folks hit hardest by work requirements
Disenrollment risk was
≈2× higher for people with diabetes
and
≈5.5× higher for older adults (40-49) with ≥3 chronic conditions
Concerning evidence the sickest and most vulnerable folks are screened out by work requirements.
4/
Disenrollment risk was
≈2× higher for people with diabetes
and
≈5.5× higher for older adults (40-49) with ≥3 chronic conditions
Concerning evidence the sickest and most vulnerable folks are screened out by work requirements.
4/
June 2, 2025 at 2:07 PM
RESULT 2: Sickest folks hit hardest by work requirements
Disenrollment risk was
≈2× higher for people with diabetes
and
≈5.5× higher for older adults (40-49) with ≥3 chronic conditions
Concerning evidence the sickest and most vulnerable folks are screened out by work requirements.
4/
Disenrollment risk was
≈2× higher for people with diabetes
and
≈5.5× higher for older adults (40-49) with ≥3 chronic conditions
Concerning evidence the sickest and most vulnerable folks are screened out by work requirements.
4/
RESULT 1: Work requirements --> coverage losses
When CT imposed WR, SNAP coverage fell 25% + Medicaid enrollment was flat.
Translation — People lost nutrition support, not because they earned more, but because of paperwork.
If they were earning more they would be losing Medicaid eligibility.
3/
When CT imposed WR, SNAP coverage fell 25% + Medicaid enrollment was flat.
Translation — People lost nutrition support, not because they earned more, but because of paperwork.
If they were earning more they would be losing Medicaid eligibility.
3/
June 2, 2025 at 2:07 PM
RESULT 1: Work requirements --> coverage losses
When CT imposed WR, SNAP coverage fell 25% + Medicaid enrollment was flat.
Translation — People lost nutrition support, not because they earned more, but because of paperwork.
If they were earning more they would be losing Medicaid eligibility.
3/
When CT imposed WR, SNAP coverage fell 25% + Medicaid enrollment was flat.
Translation — People lost nutrition support, not because they earned more, but because of paperwork.
If they were earning more they would be losing Medicaid eligibility.
3/
The effect of turning 65 on collections debt shrinks post-ACA — this makes sense since a higher share of the near-elderly already had coverage
But it shrinks less in the South—orange in the figure—and particularly Deep South states of LA, AL, MS, GA, SC, TX, and FL
Why?
5/
But it shrinks less in the South—orange in the figure—and particularly Deep South states of LA, AL, MS, GA, SC, TX, and FL
Why?
5/
January 10, 2025 at 6:57 PM
The effect of turning 65 on collections debt shrinks post-ACA — this makes sense since a higher share of the near-elderly already had coverage
But it shrinks less in the South—orange in the figure—and particularly Deep South states of LA, AL, MS, GA, SC, TX, and FL
Why?
5/
But it shrinks less in the South—orange in the figure—and particularly Deep South states of LA, AL, MS, GA, SC, TX, and FL
Why?
5/
The areas that experienced larger reductions in collections debt at age 65 were:
1️⃣ Concentrated in the Southern United States
2️⃣ Had higher shares of black residents
3️⃣ Had higher shares of people with disabilities
4️⃣ Were more likely to have for-profit hospitals.
4/
1️⃣ Concentrated in the Southern United States
2️⃣ Had higher shares of black residents
3️⃣ Had higher shares of people with disabilities
4️⃣ Were more likely to have for-profit hospitals.
4/
January 10, 2025 at 6:57 PM
The areas that experienced larger reductions in collections debt at age 65 were:
1️⃣ Concentrated in the Southern United States
2️⃣ Had higher shares of black residents
3️⃣ Had higher shares of people with disabilities
4️⃣ Were more likely to have for-profit hospitals.
4/
1️⃣ Concentrated in the Southern United States
2️⃣ Had higher shares of black residents
3️⃣ Had higher shares of people with disabilities
4️⃣ Were more likely to have for-profit hospitals.
4/
This leads to large reductions in collections debt, but small or no impact on other financial health outcomes at 65.
For collections debt, we find:
1️⃣ 30 percent reduction at 65
2️⃣ Two-thirds reduction in the geographic variation due to larger effects in the size where rates were higher
3/
For collections debt, we find:
1️⃣ 30 percent reduction at 65
2️⃣ Two-thirds reduction in the geographic variation due to larger effects in the size where rates were higher
3/
January 10, 2025 at 6:57 PM
This leads to large reductions in collections debt, but small or no impact on other financial health outcomes at 65.
For collections debt, we find:
1️⃣ 30 percent reduction at 65
2️⃣ Two-thirds reduction in the geographic variation due to larger effects in the size where rates were higher
3/
For collections debt, we find:
1️⃣ 30 percent reduction at 65
2️⃣ Two-thirds reduction in the geographic variation due to larger effects in the size where rates were higher
3/
We use a regression discontinuity design to study what happens to financial health when people turn 65, the eligibility age for Medicare coverage.
We document a large increase in coverage and reduction in debt collections.
2/
We document a large increase in coverage and reduction in debt collections.
2/
January 10, 2025 at 6:57 PM
We use a regression discontinuity design to study what happens to financial health when people turn 65, the eligibility age for Medicare coverage.
We document a large increase in coverage and reduction in debt collections.
2/
We document a large increase in coverage and reduction in debt collections.
2/
I am *THRILLED* the 2025 Economic Report of the President is highlighting the financial risk protection provided by public insurance programs
Excited to see my work with @paulgp.com and Maxim Pinkovskiy included with many other great studies
Link to the report: bit.ly/428zURZ
1/
Excited to see my work with @paulgp.com and Maxim Pinkovskiy included with many other great studies
Link to the report: bit.ly/428zURZ
1/
January 10, 2025 at 6:57 PM
I am *THRILLED* the 2025 Economic Report of the President is highlighting the financial risk protection provided by public insurance programs
Excited to see my work with @paulgp.com and Maxim Pinkovskiy included with many other great studies
Link to the report: bit.ly/428zURZ
1/
Excited to see my work with @paulgp.com and Maxim Pinkovskiy included with many other great studies
Link to the report: bit.ly/428zURZ
1/