Objective

To examine the effects of parental Medicaid eligibility on parental health, parenting practices, and child development in low-income families.

Methods

Longitudinal analysis using data from the Early Child Longitudinal Study-Kindergarten: 2011 to 2016. Outcomes included parental self-rated health, parental depressive symptoms, parents’ communication and warmth toward children, and children's social skills and externalizing and internalizing behaviors. We estimated 2-way (individual and year) fixed effects models using Medicaid eligibility as a continuous variable, controlling for changing economic conditions, changes in family structure, and state-specific trends. We then estimated triple difference models comparing lower income families to those with higher incomes. Finally, we estimated difference-in-difference models and used entropy weights in order to account for differences in trends prior to 2014 for some outcomes.

Results

In fixed effects models, expanding Medicaid eligibility by 100% of the federal poverty line is associated with a 12.7 percentage point reduction in parents’ report of having fair or poor health (95% confidence interval [CI], -23.9, -1.5) and a 1.15-point improvement on a 12-point scale of parental warmth towards children (95% CI, 0.15, 2.16). Results were substantively similar in entropy-balanced difference-in-differences models. In triple difference models, expanded Medicaid eligibility is associated with a 0.46 point improvement in warmth (95% CI, 0.10, 0.83) but not improved parental health. No significant effects for child behavior or other outcomes were detected.

Conclusions

Expanding Medicaid for parents may have implications for intergenerational family functioning that could lead to broader social benefits.

中文翻译：

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扩大父母医疗补助资格与父母健康和家庭功能的协会

客观的

研究父母医疗补助资格对低收入家庭的父母健康、育儿实践和儿童发展的影响。

方法

使用早期儿童纵向研究-幼儿园：2011 年至 2016 年的数据进行纵向分析。结果包括父母自评健康状况、父母抑郁症状、父母对孩子的沟通和温暖，以及孩子的社交技能和外化和内化行为。我们使用医疗补助资格作为连续变量来估计 2 路（个人和年度）固定效应模型，控制不断变化的经济条件、家庭结构的变化和特定州的趋势。然后，我们估计了将低收入家庭与高收入家庭进行比较的三重差异模型。最后，我们估计了差异模型并使用熵权重来解释 2014 年之前某些结果的趋势差异。

结果

在固定效应模型中，将 Medicaid 资格扩大 100% 的联邦贫困线与父母报告的健康状况一般或较差的报告减少 12.7 个百分点相关（95% 置信区间 [CI]，-23.9，-1.5）和在 12 分制的父母对孩子的温暖量表上提高了 1.15 分（95% CI，0.15，2.16）。结果在熵平衡差异模型中基本相似。在三重差异模型中，扩大医疗补助资格与温暖改善 0.46 点相关（95% CI，0.10，0.83），但未改善父母健康。未检测到对儿童行为或其他结果的显着影响。

结论

为父母扩大医疗补助可能会对代际家庭功能产生影响，从而带来更广泛的社会福利。