The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the 2014 ACA Medicaid Expansions / Kosali Simon, Aparna Soni, John Cawley.

Format:

Book

Author/Creator:

Simon, Kosali.

Contributor:

National Bureau of Economic Research.

Soni, Aparna.

Cawley, John.

Series:

Working Paper Series (National Bureau of Economic Research) no. w22265.

NBER working paper series no. w22265

Language:

English

Physical Description:

1 online resource: illustrations (black and white);

Other Title:

Impact of Health Insurance on Preventive Care and Health Behaviors

Place of Publication:

Cambridge, Mass. National Bureau of Economic Research 2016.

Summary:

The U.S. population receives suboptimal levels of preventive care and has a high prevalence of risky health behaviors. One goal of the Affordable Care Act (ACA) was to increase preventive care and improve health behaviors by expanding access to health insurance.

This paper estimates how the ACA-facilitated state-level expansions of Medicaid in 2014 affected these outcomes. Using data from the Behavioral Risk Factor Surveillance System, and a difference-in-differences model that compares states that did and did not expand Medicaid, we examine the impact of the expansions on preventive care (e.g. dental visits, immunizations, mammograms, cancer screenings), risky health behaviors (e.g. smoking, heavy drinking, lack of exercise, obesity), and self-assessed health.

We find that the expansions increased insurance coverage and access to care among the targeted population of low-income childless adults. The expansions also increased use of certain forms of preventive care but there is no evidence that they increased ex ante moral hazard (i.e., there is no evidence that risky health behaviors increased in response to health insurance coverage). The Medicaid expansions also modestly improved self-assessed health.

Notes:

Print version record

May 2016.