The Effects of a Natural Disaster on Health Care Utilization: An Evaluation of the Hurricane Katrina “TexKat” Medicaid Waivers

Policymakers make vital decisions regarding health insurance expansions that greatly affect the access to health care of vulnerable populations. Medicaid waivers are the preferred method to quickly expand health insurance coverage to low income individuals. After Hurricane Katrina, Medicaid was expanded to cover Displaced Louisiana Residents (DLRs), enabling them access to necessary health care services. We propose to evaluate the largest of these waivers, the TexKat waiver in Texas that granted 5 months of temporary Medicaid coverage to almost 60,000 DLRs. Our analysis uses an innovative approach to examine health care utilization of DLRs enrolled in the TexKat waiver. We will compare post-Katrina utilization of those previously enrolled in Louisiana Medicaid to those who were not previously enrolled and to those who were enrolled in Texas Medicaid and unaffected by the hurricane. We will also look at differences pre and post Katrina among DLRs who had Medicaid in Louisiana and were then enrolled in TexKat. A thorough investigation of one of the largest Katrina Medicaid emergency waivers could be of great use to policymakers in shaping future waivers.