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How does the affordable care act Medicaid expansion affect cigarette consumption?—The mechanism and heterogeneity

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  • Lingxiao Wang
  • Yuqing Zheng
  • Steven C. Buck

Abstract

We examine the average effect of the affordable care act (ACA) Medicaid expansion on cigarette consumption as well as heterogeneous effects by consumer types, depending on whether they use anti‐smoking products and their baseline level of cigarette consumption. Using the Nielsen homescan consumer panel and generalized difference‐in‐differences (GDD) method, we find that anti‐smoking products can induce cigarette smoking among moderate and heavy smokers. However, the ACA Medicaid expansion reduces cigarette smoking through channels other than anti‐smoking products. As a net result, the ACA Medicaid expansion leads to a reduction in smoking. Light smokers are the main beneficiaries of ACA Medicaid expansion—their average cigarette consumption reduces by over one pack per month.

Suggested Citation

  • Lingxiao Wang & Yuqing Zheng & Steven C. Buck, 2021. "How does the affordable care act Medicaid expansion affect cigarette consumption?—The mechanism and heterogeneity," Journal of Consumer Affairs, Wiley Blackwell, vol. 55(3), pages 763-791, September.
  • Handle: RePEc:bla:jconsa:v:55:y:2021:i:3:p:763-791
    DOI: 10.1111/joca.12367
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    1. Johanna Catherine Maclean & Michael F. Pesko & Steven C. Hill, 2019. "Public Insurance Expansions And Smoking Cessation Medications," Economic Inquiry, Western Economic Association International, vol. 57(4), pages 1798-1820, October.
    2. Acharya, Avidit & Blackwell, Matthew & Sen, Maya, 2016. "Explaining Causal Findings Without Bias: Detecting and Assessing Direct Effects," American Political Science Review, Cambridge University Press, vol. 110(3), pages 512-529, August.
    3. Chad Cotti & Erik Nesson & Nathan Tefft, 2019. "Impacts of the ACA Medicaid expansion on health behaviors: Evidence from household panel data," Health Economics, John Wiley & Sons, Ltd., vol. 28(2), pages 219-244, February.
    4. Yuqing Zheng & Chen Zhen & Daniel Dench & James M. Nonnemaker, 2017. "U.S. Demand for Tobacco Products in a System Framework," Health Economics, John Wiley & Sons, Ltd., vol. 26(8), pages 1067-1086, August.
    5. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1057-1106.
    6. David Card & Carlos Dobkin & Nicole Maestas, 2009. "Does Medicare Save Lives?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(2), pages 597-636.
    7. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Effects of the Affordable Care Act on Health Behaviors after Three Years," NBER Working Papers 24511, National Bureau of Economic Research, Inc.
    8. Dhaval Dave & Robert Kaestner, 2009. "Health insurance and ex ante moral hazard: evidence from Medicare," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 367-390, December.
    9. Dhaval M. Dave & Robert Kaestner & George L. Wehby, 2015. "Does Medicaid Coverage for Pregnant Women Affect Prenatal Health Behaviors?," NBER Working Papers 21049, National Bureau of Economic Research, Inc.
    10. Cutler, David M. & Zeckhauser, Richard J., 2000. "The anatomy of health insurance," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 11, pages 563-643, Elsevier.
    11. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    12. Michael R. Richards & Joachim Marti & Johanna Catherine Maclean & Jason Fletcher & Donald Kenkel, 2017. "Tobacco Control, Medicaid Coverage, and the Demand for Smoking Cessation Drugs," American Journal of Health Economics, University of Chicago Press, vol. 3(4), pages 528-549, Fall.
    13. M. Paula Fitzgerald & Thomas K. Bias & Tami Gurley-Calvez, 2017. "The Affordable Care Act and Consumer Well-Being: Knowns and Unknowns," Journal of Consumer Affairs, Wiley Blackwell, vol. 51(1), pages 27-53, March.
    14. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2017. "Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non‐Expansion States," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(1), pages 178-210, January.
    15. Kosali Simon & Aparna Soni & John Cawley, 2017. "The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(2), pages 390-417, March.
    16. Panagiotis Kasteridis & Steven T. Yen, 2014. "Occasional Smoking and Body Weight among Adults," Applied Economic Perspectives and Policy, Agricultural and Applied Economics Association, vol. 36(3), pages 479-503.
    17. Richard Connelly & Rajeev Goel & Rati Ram, 2010. "Income inequality and cigarette consumption: evidence from the United States," Applied Economics Letters, Taylor & Francis Journals, vol. 17(5), pages 423-426.
    18. Lilliard E. Richardson & Tansel Yilmazer, 2013. "Understanding the Impact of Health Reform on the States: Expansion of Coverage through Medicaid and Exchanges," Journal of Consumer Affairs, Wiley Blackwell, vol. 47(2), pages 191-218, July.
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