Undergraduate Honors Theses

Thesis Defended

Spring 2019

Document Type


Type of Thesis

Departmental Honors



First Advisor

Brian Cadena, PhD


This study examines how the Medicaid expansion has affected health coverage, medical care utilization, financial well-being, and self-reported health. This study distinguishes itself from prior literature in that it also examines how the effect of the Medicaid expansion depends upon state cost-sharing requirements. Further, the study leverages a natural experimental design based on the introduction of a policy intervention (i.e. the Medicaid expansion in 2014). A difference-in-difference regression model is first used to compare states that did and did not expand Medicaid. A second difference-in-difference regression model is then used to compare states that did not expand Medicaid, states that did expand Medicaid with cost-sharing requirements, and states that did expand Medicaid without cost-sharing requirements. Results indicate that the Medicaid expansion is associated with improvements in coverage, utilization, and financial well-being. However, it is also associated with a worsening in self-reported health outcomes. Furthermore, states that expanded Medicaid without cost-sharing requirements outperformed states that also expanded Medicaid but with cost-sharing requirements in all outcomes including self-reported health outcomes.