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Using a regression discontinuity design with data from Medical Expenditure Panel Survey and National Health and Nutrition Examination Survey for 2007\u20132019, we demonstrate that the cliff increases out\u2010of\u2010pocket spending by 25% and the probability of experiencing problems paying medical bills by 44.4% without decreases in overall health care spending. However, there is evidence that near\u2010poor Medicare beneficiaries changed behavior in response to the cliff, increasing the use of high\u2010value diagnostic and preventive testing by 8.8% and enrollment in a more affordable plan by 12.2%. The cliff does not encourage healthy behavior.<\/jats:p>","DOI":"10.1002\/hec.4902","type":"journal-article","created":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T13:45:08Z","timestamp":1727531108000},"page":"105-153","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of the Medicaid coverage cliff on low\u2010income elderly Medicare beneficiaries"],"prefix":"10.1002","volume":"34","author":[{"given":"Kanghyock","family":"Koh","sequence":"first","affiliation":[{"name":"Department of Economics Korea University, Seoul  Seongbuk\u2010gu Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sungchul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management BK21 FOUR R&amp;E Center for Learning Health Systems Korea University, Seoul  Seongbuk\u2010gu Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,28]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Choosing wisely: don\u2019t do imaging for uncomplicated headache [internet]","author":"American College of Radiology","year":"2019"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/diaclin.34.1.3"},{"key":"e_1_2_11_4_1","volume-title":"Choosing wisely: Pain medicine [Internet]","author":"American Society of Anesthesiologists","year":"2014"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1198\/016214508000000841"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1553"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1257\/pol.20140262"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/qje\/qjr042"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1257\/app.20160350"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1257\/pol.3.2.41"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1257\/aer.98.5.2242"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1162\/qjec.2009.124.2.597"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1536867x1801800115"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.2019.1635480"},{"key":"e_1_2_11_15_1","unstructured":"Centers for Medicare & Medicaid Services. 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