Medicaid Expansion and Crime Outcomes

How Medicaid expansion shapes crime outcomes remain an open but consequential question for understanding the full societal impact of U.S. health policy.The Affordable Care Act (ACA) was passed in 2010 by the U.S. federal government to tackle high costs of healthcare by substantially reconfiguring the healthcare system.A key provision was the 2014 Medicaid expansion, which extended free or low-cost public health insurance to all individuals in participating states with incomes up to 138% of the Federal Poverty Line (FPL), including previously ineligible adults without child dependents.As debates around government spending intensify, the future of Medicaid is uncertain.Against this backdrop, understanding the broader economic and social implications of Medicaid has become timely and policy relevant.While the extant literature has illustrated Medicaid's positive spillover vis-a-vis increased participation in social safety nets (Burney et al., Food Policy, 2021), as well as reductions in recidivism (Aslim et al., Health Economics, 2024), there remains limited evidence on the expansion's relationship with crime outcomes.Yet crime imposes substantial social and economic costs on communities and governments alike, making it a critical lens through which to assess the value of public policy.This paper aims to fill that gap by using county-level crime data and exploiting state-level variation in policy adoption to identify the effects of Medicaid expansion on both violent and property crime.By applying a contiguous border-county-pair fixed-effects