Graduation Year


Date of Submission


Document Type

Campus Only Senior Thesis

Degree Name

Bachelor of Arts



Second Department


Reader 1

Eric Helland

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2021 Olivia S Welsh


This paper examines the relationship between Medicaid eligibility and housing outcomes for low-income individuals and families. In the 12 states that have failed to expand Medicaid eligibility under the Affordable Care Act (ACA), many low-income adults have fallen into the Medicaid ‘coverage gap.’ Uninsured individuals and families are fully responsible for their medical expenses and have less funds available for housing. Health insurance reduces the financial burden of medical care, allowing for increased housing expenditure. To test the effect of Medicaid eligibility on housing outcomes, I use the U.S. Census Bureau’s American Community Survey (ACS) micro-data and implement a two-stage least-squares (2SLS) estimation using a linear probability model. This analysis finds that Medicaid enrollment is associated with a 38.4% decrease in the probability of living in inadequate housing. Medicaid coverage is also associated with a 32.7% increase in the probability of living in unaffordable housing. Unaffordable housing is an indicator of individuals and families spending a greater portion of their monthly income on housing, rather than on medical expenses. Given that earning Medicaid coverage may encourage individuals to spend more on housing, it is crucial that improved healthcare security does not increase rates of housing insecurity. One of the most effective policy levers for addressing the tradeoff between Medicaid coverage and housing security is the use of Section 1115 waivers to link additional housing assistance to Medicaid programs. This is relevant given that housing is a central social determinant of health, alongside factors such as socioeconomic status, education, and employment.

This thesis is restricted to the Claremont Colleges current faculty, students, and staff.