Fed/GFLEC Financial Literacy Seminar Series

April 6, 2023

3:30 PM - 4:30 PM ET

Seminar III: Insurance, Out-of-Pocket Expenses, and Financial Hardship Among Individuals Approaching Retirement: Evidence from State Medicaid Expansions

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Keisha Solomon

Research Scientist, Department of Economics, Howard University





Keisha Solomon is a research scientist based at Howard University. With a Ph.D. in Economics from Temple University, Keisha has established herself as an expert in applied microeconomist with a special interest in mental health, substance use, policy evaluation, causal inference, labor economics, and health equity.

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The Patient Protection and Affordable Care Act (ACA) created new health insurance options for many individuals and increased protection from unaffordable health care expenses. Research demonstrates how public health insurance improved the economic well-being of households overall. But whether there are specific benefits to households not yet eligible for Medicare but potentially with high health care needs is less understood. This research examines how the availability of public health insurance affects the economic security of below median income households aged 45 through 64. We test if Medicaid access affects unexpected out-of-pocket healthcare spending and financial hardship for households approaching retirement using the 2013 through 2019 Survey of Household Economics and Decisionmaking (SHED). Based on state-level decisions to expand Medicaid access, we find increases in health insurance coverage but little difference in out-of-pocket spending or financial hardship for these households approaching retirement.