Are coresidence and nursing homes substitutes? Evidence from Medicaid spend-down provisions

共同居住和养老院可以互相替代吗?来自医疗补助计划资产消耗条款的证据

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Abstract

This paper measures the extent to which the price of nursing home care affects a potential substitute living arrangement: coresidence with adult children. Exploiting variation in state Medicaid income "spend-down" provisions over time, I find that living in a state with a spend-down provision decreases the prevalence of coresidence with adult children by 1-4 percentage points for single elderly individuals, with a corresponding increase in the use of nursing home care. These findings suggest that changes in Medicaid eligibility for long-term care benefits could have large impacts on living arrangements, care utilization patterns, and Medicaid expenditures.

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