These findings have implications for the ongoing debate over approaches for expanding coverage, particularly within states seeking waivers to adopt partial Medicaid expansions. Although researchers could not definitively conclude that total health care expenditures for Medicaid enrollees were less than for marketplace enrollees, the findings may help policymakers better understand how health care expenditures inform the total cost of health care. For example, relying more on the ACA marketplace to expand health insurance coverage could increase total expenditures, given marketplace enrollees’ higher per capita spending across certain services.
Policymakers also need to take other factors into account, such as administrative costs, cost-sharing, and network quality, to know whether expanding Medicaid or marketplace plans is more desirable.
About the Urban Institute
The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.