The Effects of State Medicaid Policies on the Dynamic Savings Patterns and Medicaid Enrollment of the Elderly

Medicaid policies that may affect long-term care decisions vary across states and time. Using data from the 1993, 1995, 1998, and 2000 waves of the Assets and Health Dynamics Among the Oldest Old Survey, we estimate a dynamic empirical model of health insurance coverage, long-term care arrangement, asset and gift behavior, and health transitions over time. Long-run simulations from the estimated model reveal that most Medicaid eligibility and generosity policy variables associated with nursing home services have no effect on Medicaid enrollment and asset behavior. Those policies related to home- and community-based services, however, have a significant but small influence.