Long-Term Impacts of Childhood Medicaid Expansions on Outcomes in Adulthood

TLDR

The study examines the long‑term effects of childhood Medicaid eligibility expansions on adult outcomes from ages 19 to 28. It uses IRS administrative data to conduct this analysis. Greater childhood Medicaid eligibility raises college enrollment, reduces fertility through age 21, improves female wage income after age 23, lowers mortality for both sexes, reduces earned‑income tax credit receipts, increases tax payments, and yields a net federal return of 58 cents per dollar invested over ages 19–28.

Abstract

Abstract We use administrative data from the Internal Revenue Service to examine long-term impacts of childhood Medicaid eligibility expansions on outcomes in adulthood at each age from 19 to 28. Greater Medicaid eligibility increases college enrolment and decreases fertility, especially through age 21. Starting at age 23, females have higher contemporaneous wage income, although male increases are imprecise. Together, both genders have lower mortality. These adults collect less from the earned income tax credit and pay more in taxes. Cumulatively from ages 19 to 28, at a 3% discount rate, the federal government recoups 58 cents of each dollar of its “investment” in childhood Medicaid.