Some states have not adopted the Affordable Care Act (ACA) Medicaid expansions due to concerns that the expansions may impair access to care and utilization for those who are already insured. We investigate such negative spillovers using a large panel of Medicare beneficiaries. Across many subgroups and outcomes, we find no evidence that the expansions reduced utilization among Medicare beneficiaries and can rule out all but very small changes in utilization or spending. These results indicate that the expansions in Medicaid did not impair access to care or utilization for the Medicare population.

中文翻译：

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保险扩张对已投保人的影响：平价医疗法案和医疗保险

由于担心扩展可能会损害已经投保的人获得护理和使用的机会，一些州尚未通过《平价医疗法案》(ACA) 医疗补助扩展。我们使用一大群医疗保险受益人来调查这种负面溢出。在许多亚组和结果中，我们没有发现任何证据表明扩张降低了医疗保险受益人的利用率，并且可以排除利用率或支出的非常小的变化。这些结果表明，医疗补助的扩张并未损害医疗保险人群获得护理或使用的机会。