Geocoded Medicaid office locations in the United States

Big “p” policy changes at the state and federal level are certainly important to health equity, such as eligibility for and generosity of Medicaid benefits. Medicaid expansion has significantly expanded the number of people who are eligible for Medicaid and the creation of the health insurance exchanges (Marketplace) under the Affordable Care Act created a very visible avenue through which people can learn that they are eligible. Although many applications are now submitted online, physical access to state, county, and tribal government Medicaid offices still plays a critical role in understanding eligibility, getting help in applying, and navigating required documentation for both initial enrollment and redetermination of eligibility. However, as more government functions have moved online, in-person office locations and/or staff may have been cut to reduce costs, and gentrification has shifted where minoritized, marginalized, and/or low-income populations live, it is unclear if this key local connection point between residents and Medicaid has been maintained. Our objective was to identify and geocode all Medicaid offices in the United States for pairing with other spatial data (e.g., demographics, Medicaid participation, health care use, health outcomes) to investigate policy-relevant research questions. Three coders identified Medicaid office addresses in all 50 states and the District of Columbia by searching state government websites (e.g., Department of Health and Human Services or analogous state agency) during late 2021 and early 2022 for the appropriate Medicaid agency and its office locations, which were then reviewed for accuracy by a fourth coder. Our corpus of Medicaid office addresses was then geocoded using the Census Geocoder from the US Census Bureau (https://geocoding.geo.census.gov/geocoder/) with unresolved addresses investigated and/or manually geocoded using Google Maps. The corpus was updated in August through December 2023 following the end of the COVID-19 public health emergency by a fifth coder as several states closed and/or combined offices during the pandemic. After deduplication (e.g., where multiple counties share a single office) and removal of mailing addresses (e.g., PO Boxes), our dataset includes 3,027 Medicaid office locations. 1 (December 19, 2023) – original version 2 (January 25, 2024) – added related publication (Data in Brief), corrected two records that were missing negative signs in longitude 3 (February 6, 2024) – corrected latitude and longitude for one office (1340 State Route 9, Lake George, NY 12845) 4 (March 4, 2024) – added one office for Vermont after contacting relevant state agency (280 State Road, Waterbury, VT 05671)

州与联邦层面的重大政策（Big "p" policy）调整对健康公平至关重要，例如医疗补助计划（Medicaid）的资格认定与福利覆盖范围。医疗补助计划扩容大幅扩大了符合Medicaid资格的人群规模；而《平价医疗法案》（Affordable Care Act）下设立的健康保险交易所（Marketplace），则为民众了解自身参保资格提供了清晰的途径。尽管当前多数申请可在线提交，但民众亲临州、县及部落政府的Medicaid办事处，仍在资格核查、申请协助以及初始参保登记与资格重新认定所需文件的办理流程中发挥关键作用。然而，随着更多政府职能线上化，为压缩成本，线下办事处的点位与工作人员或遭裁减；同时，绅士化进程改变了少数族裔、边缘群体及低收入人群的聚居区域，因此民众与Medicaid之间的这一关键本地联络渠道是否得以保留，尚不明确。

本研究旨在识别并地理编码美国境内所有Medicaid办事处，以便与其他空间数据（如人口统计数据、Medicaid参保数据、医疗服务使用数据及健康结局数据）进行匹配，进而开展与政策相关的研究。2021年末至2022年初，三名编码员通过检索州政府官网（如卫生与公众服务部或同类州级机构），获取全美50州及哥伦比亚特区的Medicaid办事处地址，随后由第四名编码员对地址的准确性进行复核。随后，研究团队使用美国人口普查局（US Census Bureau）的人口普查地理编码器（Census Geocoder，https://geocoding.geo.census.gov/geocoder/）对采集到的Medicaid办事处地址进行地理编码；对于无法识别的地址，则通过谷歌地图（Google Maps）进行人工核查并完成地理编码。2023年8月至12月，即新冠疫情公共卫生紧急状态结束后，第五名编码员对地址库进行了更新——疫情期间多个州关停或合并了办事处，因此需对数据进行修订。经去重（如多个县共用同一办事处的情况）及剔除邮寄地址（如邮政信箱地址）后，本数据集共包含3027个Medicaid办事处点位。

1. 2023年12月19日：初始版本
2. 2024年1月25日：新增相关出版物《数据简报》（Data in Brief），修正了2条记录中经度缺失负号的问题
3. 2024年2月6日：修正1处办事处的经纬度信息（纽约州乔治湖市9号州道1340号，邮编12845）
4. 2024年3月4日：通过联系佛蒙特州相关机构，新增1处办事处（佛蒙特州沃特伯里市280号州道，邮编05671）