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Original Publication Date
2026
Document Type
Video
Abstract
Since the passage of the Patient Protection and Affordable Care Act (ACA) in 2010, Medicaid eligibility has expanded significantly, yet the adoption of this expansion remains non-universal across U.S. states. While the general effects of Medicaid expansion are well-documented, its specific impact on immigrant populations remains a critical gap in public policy literature. This study utilizes panel data from 2017 to 2023 to analyze how state-level policy choices and political leadership influence Medicaid enrollment rates among immigrants.
The study employed Ordinary Least Squares (OLS) regression and interaction terms to isolate the effects of two primary independent variables: Medicaid expansion status and the political party of state governors. The analysis controlled for state GDP, total population, child enrollment, and time trends, drawing from robust federal sources including the CMS, Bureau of Economic Analysis, and the U.S. Census Bureau.
Key Findings:
- Expansion as a Primary Driver: Expansion states demonstrated a 28 percentage point higher enrollment rate for immigrants compared to non-expansion states, confirming that policy adoption is the strongest predictor of healthcare access for this demographic.
- The Role of Political Ideology: Democratic-led states showed higher enrollment rates than Republican-led states. Specifically, among states that had expanded Medicaid, Republican-led administrations saw approximately 1 percentage point fewer enrollments than their Democratic counterparts, though this specific sub-finding was not statistically significant.
- Economic Leverage: A state’s GDP correlates positively with enrollment, suggesting that states with greater economic capacity have more leverage to incorporate immigrant populations into healthcare programs.
- Federal Matching: The data underscores the importance of the federal-state matching fund, particularly for low-GDP states that may struggle to provide coverage without increased federal support.
Keywords
Medicaid expansion, Immigrant healthcare, Affordable Care Act (ACA), Healthcare access
Rights
Copyright © 2026 Issa Belmond Thullah. All rights reserved.
Comments
Presented in the Vulnerable Populations and Social Welfare Policy session.