The Effects of Health Care Benefits: A Randomized Trial for Disability Insurance Beneficiaries

WCPC Seminar Series on Poverty and Policy: Spring 2012

Presented by Charles Michalopoulos,
Chief Economist
MDRC (Manpower Demonstration Research Corporation)
Monday, May 21, 2012;  12:30 - 1:30 p.m., questions / discussion until 2:00 p.m.
Parrington Hall Commons, Room 308
University of Washington


Charles Michalopoulos, Senior Economist at MDRC, is an expert on experimental and nonexperimental statistical methods for conducting social policy evaluations, and on social policies for more disadvantaged groups. His most recent work focuses on MDRC’s growing agenda related to health — he is co-principal investigator on a national evaluation of home visiting programs for disadvantaged mothers funded and authorized by the federal health care legislation, is leading two MDRC evaluations of coordinated care for high-cost Medicaid recipients, and is conducting an impact analysis of care management for depressed Medicaid recipients in Rhode Island. He was also co-principal investigator for the Accelerated Benefits Demonstration, an evaluation of the effects of offering health care coverage to new uninsured recipients of Disability Insurance benefits. His earlier work has included studies of financial work incentives for welfare recipients, child care subsidy policies, and programs that aim to strengthen the marriages of low-income couples. Among his publications are several reports and articles synthesizing the effects of welfare and work policies, employment and training programs, and financial work incentives. Michalopoulos earned a doctorate in economics from the University of Wisconsin–Madison in 1994 and was an assistant professor in the Department of Economics at Virginia Tech.


Under current law, most Social Security Disability Insurance beneficiaries are not eligible for Medicare until 29 months after the onset of their disability. During this “waiting period,” most beneficiaries have poor health and a high demand for health care: the average new SSDI beneficiary makes 22 doctor visits and spends seven days hospitalized in the year after they begin receiving SSDI benefits. Despite this health care need, more than one in five new beneficiaries lacks health insurance. The Accelerated Benefits Demonstration investigated the effects of providing health care benefits on the health, employment, and other services of uninsured beneficiaries. New SSDI beneficiaries without health insurance were randomly assigned to receive health care benefits, health care benefits plus additional supports, or a control group.

Compared with the control group, those provided health care benefits used more health care, had fewer unmet medical needs, spent less out-of-pocket on health care, and reported improved health. In addition, those provided the additional supports were more likely to look for work, but the supports did not affect work or SSDI benefits at this very early period. The results provide rigorous evidence that health care benefits can increase health care use and health outcomes. Longer-term follow-up is needed to fully assess the program’s effects on its ultimate benefits and costs, including its long-term effects on health, employment and benefit receipt.


See the slides from this presentation here.