Understanding Cross-State Variations in Medicaid Enrollment During and After the COVID-19 Pandemic / Jeffrey Clemens, Helena Detering, Anwita Mahajan.

Format:

Book

Author/Creator:

Clemens, Jeffrey.

Contributor:

Detering, Helena.

Mahajan, Anwita.

National Bureau of Economic Research.

Series:

Working Paper Series (National Bureau of Economic Research) no. w35399.

NBER working paper series no. w35399

Language:

English

Physical Description:

1 online resource: illustrations (black and white);

Place of Publication:

Cambridge, Mass. National Bureau of Economic Research 2026.

Summary:

The implementation and unwinding of the FFCRA's continuous coverage requirement generated historically large changes in Medicaid enrollment during the COVID-19 pandemic. Using a combination of descriptive and causal analyses, we examine the substantial cross-state differences in these changes, which remain little understood. We find that policies designed to ease unwinding frictions, as well as federal fiscal assistance to states, have little predictive power, suggesting limited roles for administrative design or liquidity constraints. Political preferences have modest predictive power during the unwinding period. Pandemic-era Medicaid expansions and more generous baseline eligibility thresholds are strongly associated with larger net enrollment gains.

Notes:

July 2026.

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