Expanding public health insurance to parents : Effect on parents' and children’s well-being

• Main Authors: MARCUS, Michelle, ZHANG, Xuan
• Format: text
• Language: English
• Published: Institutional Knowledge at Singapore Management University 2026
• Subjects: Medicaid; Parents; Children; Healthcare access; Healthcare utilization; Health status; Financial burden; Health Economics
• Online Access: https://ink.library.smu.edu.sg/soe_research/2786; https://ink.library.smu.edu.sg/context/soe_research/article/3785/viewcontent/ACA_children_AJHE__2_.pdf
• Institution: Singapore Management University

Expanding public health insurance to parents may not only improve parental outcomes but also have spillover effects on their children. This paper leverages the natural experiment of the Affordable Care Act (ACA) to estimate the causal effects of expanding public health insurance to low-income parents on their well-being and that of their children. Using a difference-in-differences model and data from the 2010–2017 National Health Interview Surveys, we observe significant improvements in health care access, increased health care utilization, reduced financial burdens, and slight improvements in health status among low-income parents. For children in Medicaid expansion states, we find reductions in emergency care utilization and hospitalizations. These results highlight the short-term positive spillover effects of parental insurance coverage on children’s well-being, primarily through improved health care utilization.