Racial Disparities in SSI Enrollment Across Medicaid Managed Care Plans

This study analyzes racial and ethnic differences in the Medicaid managed care options available to SSI recipients and how plan turnover differs by race and ethnicity. It uses data from the 2018 and 2019 Medicaid Transformed Analytic Files (TAF) from 9 states, selected because they have mandatory managed care for SSI recipients and high-quality race/ethnicity identifiers according to the DQ Atlas. The study finds that:

• As of 2019, more than 75% of adult SSI recipients were enrolled in comprehensive Medicaid managed care plans.
• On average, SSI recipients from minority racial and ethnic groups have more managed care plan options than White SSI recipients. They also tend to enroll in larger plans with larger numbers of SSI enrollees.
• SSI recipients of different races and ethnicities switch plans at about the same rates, but their reasons for switching plans differ. White and Black SSI recipients are most likely to actively choose new plans; Hispanic SSI recipients and recipients from other minority groups are more likely to be forced to switch plans due to plan terminations.
• Among those not subject to plan terminations, and thus making an active choice to retain or switch plans, the results suggest that White and Black SSI recipients were the least satisfied with their Medicaid managed care plans.

Since different managed care plans have different provider networks, the plan options available to SSI beneficiaries and the plans they choose may in turn impact their healthcare utilization and health outcomes. This study explores some of the differences in plan availability and choice among SSI recipients from different racial and ethnic groups.