4.1 Article

The effects of Medicaid expansion on home production and childcare

Journal

SOUTHERN ECONOMIC JOURNAL
Volume 88, Issue 3, Pages 931-950

Publisher

WILEY
DOI: 10.1002/soej.12554

Keywords

childcare; difference-in-difference; household production; Medicaid; public health insurance; time use

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The study shows that expanding Medicaid can increase the time spent on home production for low-income adults and childcare for low-income parents. This increased time may have significant health benefits for both children and adults.
Public health insurance programs like Medicaid provide in-kind resources that may improve health and reduce stress, altering time use patterns. Our study examines the effects of the Affordable Care Act (ACA)-facilitated Medicaid expansions on time spent on home production and childcare. Using time-diary data, we estimated difference-in-differences models comparing the time use patterns of individuals in states that expanded Medicaid versus non-expansion states, before and after implementation. Medicaid expansion increased the amount of time low-income adults spent on home production by 12 min per day (p < .05), equivalent to a 9.5% increase. This was driven by increased time spent on food preparation and housework. Medicaid expansion also increased time spent on childcare among low-income parents by 6.6 min per day (p < .10) or 7.7%. Expanding public health insurance eligibility for low-income populations may increase time spent on home production and childcare, which are associated with significant health benefits for children and adults.

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