Evidence map›Paper›PMID 26957670›Full record

ArticlePublic health reports (Washington, D.C. : 1974)

The Great Recession of 2007-2009 and Public Insurance Coverage for Children in Alabama: Enrollment and Claims Data from 1999-2011.

Michael A Morrisey, Justin Blackburn, David J Becker, Bisakha Sen, Meredith L Kilgore, Cathy Caldwell, Nir Menachemi

Abstract read
In one paragraph

Article in Public health reports (Washington, D.C. : 1974). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. What the Group Threat Hypothesis Notes About States' Medicaid Spending.Journal of racial and ethnic health disparities · 2019
    Article
  2. Trends in Medicaid Administrative Expenditures During the COVID-19 Public Health Emergency.Inquiry : a journal of medical care organization, provision and financing
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Michael A MorriseyTexas A&M University, School of Public Health, Department of Health Policy and Management, College Station, TX.
Justin BlackburnUniversity of Alabama at Birmingham School of Public Health, Department of Health Care Organization and Policy, Birmingham, AL; University of Alabama at Birmingham Lister Hill Center for Health Policy, Birmingham, AL.
David J BeckerUniversity of Alabama at Birmingham School of Public Health, Department of Health Care Organization and Policy, Birmingham, AL; University of Alabama at Birmingham Lister Hill Center for Health Policy, Birmingham, AL.
Bisakha SenUniversity of Alabama at Birmingham School of Public Health, Department of Health Care Organization and Policy, Birmingham, AL; University of Alabama at Birmingham Lister Hill Center for Health Policy, Birmingham, AL.
Meredith L KilgoreUniversity of Alabama at Birmingham School of Public Health, Department of Health Care Organization and Policy, Birmingham, AL; University of Alabama at Birmingham Lister Hill Center for Health Policy, Birmingham, AL.
Cathy CaldwellBureau of Children's Health Insurance, Alabama Department of Public Health, Montgomery, AL.
Nir MenachemiIndiana University, Richard M. Fairbanks School of Public Health, Department of Health Policy and Management, Indianapolis, IN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study examined the impact of the Great Recession of 2007-2009 on public health insurance enrollment and expenditures in Alabama. Our analysis was designed to provide a framework for other states to conduct similar analyses to better understand the relationship between macroeconomic conditions and public health insurance costs.

methodsWe analyzed enrollment and claims data from Medicaid and the Children's Health Insurance Program (CHIP) in Alabama from 1999 through 2011. We examined the relationship between county-level unemployment rates and enrollment in Medicaid and CHIP, as well as total county-level expenditures in the two programs. We used linear regressions with county fixed effects to estimate the impact of unemployment changes on enrollment and expenditures after controlling for population and programmatic changes in eligibility and cost sharing.

resultsA one-percentage-point increase in a county's unemployment rate was associated with a 4.3% increase in Medicaid enrollment, a 0.9% increase in CHIP enrollment, and an overall increase in public health insurance enrollment of 3.7%. Each percentage-point increase in unemployment was associated with a 6.2% increase in total public health insurance expenditures on children, with Medicaid spending rising by 7.5% and CHIP spending rising by 1.8%. In response to the 6.4 percentage-point increase in the state's unemployment rate during the Great Recession, combined enrollment of children in Alabama's public health insurance programs increased by 24% and total expenditures rose by 40%.

conclusionRecessions have a substantial impact on the number of children enrolled in CHIP and Medicaid, and a disproportionate impact on program spending. Programs should be aware of the likely magnitudes of the effects in their budget planning.

Indexed as

Economic RecessionAdolescentAlabamaChildChild, PreschoolChildren's Health Insurance ProgramHumansInfantInfant, NewbornInsurance CoverageMedicaidModels, EconomicUnemploymentUnited States

Identifiers

PMID26957670
PMCPMC4765984

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.