# The Effects of the Affordable Care Act Medicaid Expansion on Informal Care

> **NIH NIH R03** · UNIVERSITY OF WISCONSIN-MADISON · 2022 · $297,680

## Abstract

Abstract
Over 70 percent of older adults aged 65 or older require assistance from caregivers with basic functions at
some point in their lifetime, and most of that care is provided informally by families and friends. These informal
caregivers, especially those to older adults with Alzheimer’s disease and Alzheimer’s disease-related
dementias (AD/ADRD), bear huge physical, phycological, and financial costs which limit their ability to provide
care. The most recent Medicaid expansion under the Patient Protection and Affordable Care Act (ACA-ME)
has been shown to substantially increase health insurance coverage and health care utilization, improve
enrollees’ physical and mental health and financial security, and influence their labor market outcomes. All
these effects could be potential mechanisms through which the ACA-ME impacts informal care. However,
despite the large number of studies on ACA-ME, little is known about its effects on informal care for older
adults. We propose to fill this gap by examining the effects of the ACA-ME on informal care provided to and
received by older adults. Specifically, we will use a difference-in-differences approach and compare informal
care provision and receipt among individuals living in states that expanded their Medicaid program before and
after the expansion relative to the change in informal care provision and receipt experienced by comparable
individuals living in non-expansion states over the same period. We will use the American Time Use Survey to
measure informal care provided by low-income adults aged 18 to 64 who are most likely to be affected by the
ACA-ME. We will use the Health Retirement Study to measure informal care received by older adults. By
considering this spillover effect of the ACA-ME on informal care, the proposed project will be important for
policymakers interested in designing more effective policies to sustain or even increase the supply of informal
care to meet the escalating demand and for those interested in a more comprehensive evaluation of the ACA-
ME.

## Key facts

- **NIH application ID:** 10351420
- **Project number:** 1R03AG075318-01
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** Yang Wang
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $297,680
- **Award type:** 1
- **Project period:** 2022-04-15 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10351420

## Citation

> US National Institutes of Health, RePORTER application 10351420, The Effects of the Affordable Care Act Medicaid Expansion on Informal Care (1R03AG075318-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10351420. Licensed CC0.

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