This paper investigates the effects of the Medicaid expansion provision of the Affordable Care Act (ACA) on households’ financial health. Our findings indicate that, in addition to reducing the incidence of unpaid medical bills, the reform provided substantial indirect financial benefits to households. Using a nationally representative panel of 5 million credit records, we find that the expansion reduced unpaid medical bills sent to collection by $3.4 billion in its first two years, prevented new delinquencies, and improved credit scores. Using data on credit offers and pricing, we document that improvements in households’ financial health led to better terms for available credit valued at $250 million per year. We calculated that the financial benefits of Medicaid double when considering these indirect benefits in addition to the direct reduction in out-of-pocket expenditures.

More on this topic

BFI Working Paper·Feb 23, 2026

Multidimensional Signaling and the Rise of Cultural Politics

Daron Acemoglu, Georgy Egorov, and Konstantin Sonin
Topics: Uncategorized
BFI Working Paper·Feb 2, 2026

Diversionary Escalation: Theory and Evidence from Eastern Ukraine

Natalie Ayers, Christopher W. Blair, Joseph J. Ruggiero, Konstantin Sonin, and Austin Wright
Topics: Uncategorized
BFI Working Paper·Jan 26, 2026

Never Enough: Dynamic Status Incentives in Organizations

Leonardo Bursztyn, Ewan Rawcliffe, and Hans-Joachim Voth
Topics: Uncategorized