Cornelio, Noelle
(2023)
Eligibility and Enrollment in Medicaid for Low-Income Medicare Beneficiaries: The Role of State Policy.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Approximately 12 million low-income Medicare beneficiaries are dually enrolled in Medicaid, which pays for services not covered by Medicare and defrays out-of-pocket costs, which can be substantial for relatively poor people. Medicare’s premiums, deductibles, and coinsurance average over 40% of an individual’s Social Security income, which represents the sole source or majority of income for many low-income Medicare beneficiaries. Medicaid coverage enables low-income Medicare beneficiaries to afford care they might otherwise forego due to cost and encourages timely utilization of necessary health care services. However, poor coordination between safety net programs, complex Medicaid eligibility and enrollment rules, and state variation in Medicaid rules create substantial differences in who is eligible for and who receives Medicaid. This dissertation focuses on how variation in state Medicaid policy affects Medicaid eligibility and enrollment, cost-related barriers to care, and heath care utilization in low-income aging and disabled populations.
In the first project, I examine changes in Medicaid take-up associated with policy reforms in states that broadened Medicaid eligibility and simplified enrollment for older and disabled individuals with Medicare using a difference-in-differences design. In the second project, I assess opportunities to increase joint enrollment in Medicaid and the Supplemental Nutrition Assistance Program (SNAP) and measure state variation in Medicaid and SNAP enrollment among low-income individuals 65 and older. The final project, I utilize a simulated Medicaid eligibility index to evaluate whether broadening Medicaid eligibility and simplifying enrollment for older adults who were dually eligible for Medicare affected the length of Medicaid enrollment, access to care, or utilization of health care services.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
3 January 2023 |
| Date Type: |
Publication |
| Defense Date: |
11 November 2022 |
| Approval Date: |
3 January 2023 |
| Submission Date: |
14 December 2022 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
114 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Health Policy & Management |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Medicaid, Medicare, SNAP, eligibility, enrollment, access, utilization, senior, disabled |
| Date Deposited: |
03 Jan 2023 15:14 |
| Last Modified: |
03 Jan 2023 15:14 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/44025 |
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