理解 COVID-19 大流行期间及之后各州医疗补助登记的差异
Understanding Cross-State Variations in Medicaid Enrollment During and After the COVID-19 Pandemic
NBER Working Papers · 2026 · [{"name": "Jeffrey Clemens", "affiliation": []}, {"name": "Helena Detering", "affiliation": []}, {"name": "Anwita Mahajan", "affiliation": []}]
中文摘要
FFCRA（《家庭第一冠状病毒应对法案》）连续参保要求的实施与退出，在 COVID-19 大流行期间导致 Medicaid 参保人数出现历史性的大幅变动。我们结合描述性分析与因果分析，考察了这些变动在各州之间存在的巨大差异——这些差异至今仍知之甚少。我们发现，旨在缓解退出摩擦的政策以及联邦对各州的财政援助，其预测力都很弱，表明行政设计或流动性约束所起的作用有限。政治偏好在退出期间具有适度的预测力。大流行时期的 Medicaid 扩张以及更为慷慨的基准资格门槛，与更大的净参保增幅密切相关。
Abstract
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.