We propose the following specific aims: 1) Examine whether state expansion of Medicaid through the ACA is associated with shifts in SNAP enrollment 2) Examine whether state expansion of Medicaid through the ACA is associated with changes in the SNAP eligibility enrollment gap; 3) Examine the association between Medicaid enrollment, SNAP participation, or the combination of both, with food insecurity among income-eligible families.
We will use nationally representative, longitudinal data from the Panel Study of Income Dynamics (PSID) supplemented by USDA ERS information on county and state SNAP eligibility criteria to conduct difference in differences analyses comparing SNAP participation and SNAP benefits before and after ACA implementation among states that did and did not expand Medicaid. Aim 3 analyses will compare food insecurity in 2015/2017 among households living in states that did and did not expand Medicaid. This study has two main innovations. The first is based on our use of a comprehensive, nationally representative, longitudinal dataset with detailed information for a large sample of families in all 50 states. To date, this extensive dataset has not been used to examine nutrition assistance programs and food security outcomes. This study innovates by using this large, longitudinal cohort to examine new, previously unexplored research questions. The second innovation is in our approach which exploits a nation-wide natural experiment (a state?s decision to expand Medicaid through the ACA) to examine possible spillover effects for SNAP participation, SNAP eligibility and enrollment, and food security.