The Effect of Health Insurance on Food Security: Evidence From the Affordable Care Act's Medicaid Expansions

Georgia Himmelstein , Princeton University

Many Americans suffer food insecurity, the inability to afford enough food at all times. Research indicates that lower income Americans often make choices between meeting basic needs, such as food and health care costs. This paper examines whether the provision of health insurance improves adults' ability to meet basic needs. Using data from the annual Food Security Supplement to the Current Population Survey (CPS), I examine the effect of state-level Medicaid expansions under the 2010 Affordable Care Act (ACA) on the prevalence of severe food insecurity, using a difference-in-difference approach that compares residents of states that did and did not expand Medicaid. States that expanded Medicaid saw significantly reduced rates of very low food security among low-income childless adults, many of whom became newly eligible for Medicaid. This reduction in food insecurity suggests that expanding health insurance coverage may be a useful component of holistic anti-poverty policies.

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 Presented in Session 8. Economy, Labor Force, Education, & Inequality