People lacking insurance not likely to migrate to obtain Medicaid coverage

Amidst the patchwork nature of Medicaid expansion in the U.S. under the Affordable Care Act (ACA), some have worried that low-income adults in states without expanded coverage might move to states that have chosen to expand—thus placing a financial burden on those states. But a new Harvard School of Public Health (HSPH) study finds little evidence of such cross-state migration.

“Though many states have not opted in to the ACA Medicaid expansion, they may decide to do so in the future. Our study can inform these decisions by showing what happened when states implemented similar public insurance expansions in the past. We found no evidence that these states became so-called ‘welfare magnets,’ attracting low-income individuals from other states,” said lead author Aaron Schwartz, a doctoral candidate in health policy at Harvard.

The study was published in the January 2014 issue of Health Affairs—and was one of several in the issue co-authored by Harvard School of Public Health researchers.