Medicaid Expansion Could Prevent Evictions

As of August 2019, 37 states have adopted and implemented a Medicaid expansion that extends Medicaid eligibility to uninsured people whose incomes are at or below 138 percent of the federal poverty level. Prior research shows that Medicaid expansion has numerous positive effects on health-related and economic outcomes, among which are reductions in uninsurance rates among people with low incomes, improved self-reported health, increased utilization of medical services, reductions in medical debt, and gains in employment. Seeking to understand other potential benefits of Medicaid expansion, a group of researchers designed a study to measure the impact of Medicaid expansion on eviction rates.

To conduct their study, the researchers used a quasi-experimental difference-in-differences design to compare the number of evictions in California counties that adopted early Medicaid expansion (the treatment group) with counties in 14 states (including California) that were not part of the early Medicaid expansion (the control group). The data were collected from the American Information Research Services commercial evictions database. Variables of interest included the number of evictions per month, the number of evictions per capita, the log of evictions, and the number of evictions per rental unit.

The researchers found that Medicaid expansion in California was associated with a reduction in the number of evictions occurring in early Medicaid expansion counties. One key limitation to their data collection method was that the data were not received at an individual level, so the researchers could not match individual insurance status to whether an individual had been evicted. Instead, this method provided an aggregate number of evictions per county, which the researchers could then compare with whether or not the county had implemented Medicaid expansion.

Key findings

• Medicaid expansion was associated with 24.517 fewer evictions per month in each county, compared with a preexpansion mean of 224.718 evictions per month. This means that for every thousand new Medicaid enrollees, there were approximately 22 fewer evictions per year.
• Expansion was also associated with a 2.9 percentage point reduction in evictions per capita.
• The effect of Medicaid expansion was most distinct in counties with above-median shares of uninsured residents before expansion.

Policy implications

• The research suggests that Medicaid-expanding states will see improvements in housing security among low-income renters. The authors cite that their finding is in alignment with other research on the ability of Medicaid coverage to reduce adverse financial outcomes, including high out-of-pocket medical spending and medical debt, which can inhibit a person’s ability to pay rent.

Photo by Monkey Business Images/Shutterstock