IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v28y2019i5p666-677.html
   My bibliography  Save this article

Health insurance and opioid deaths: Evidence from the Affordable Care Act young adult provision

Author

Listed:
  • Gal Wettstein

Abstract

The concurrence of health insurance expansion under the Affordable Care Act (ACA) and increasing opioid‐related mortality has led to debate whether insurance increases or decreases opioid deaths. I use the introduction of the ACA young adult (YA) provision as a quasi‐experiment and utilize the resulting policy‐induced variation across states over time in YA access to insurance to study the effect of coverage on opioid‐related mortality. I rely on the share of state populations which stood to gain insurance before the ACA to perform a dose–response analysis, and find that the YA provision reduced opioid‐related mortality. The analysis suggests that 1 percentage point more coverage reduced opioid mortality among YA by 2.5/100,000 or 19.8%.

Suggested Citation

  • Gal Wettstein, 2019. "Health insurance and opioid deaths: Evidence from the Affordable Care Act young adult provision," Health Economics, John Wiley & Sons, Ltd., vol. 28(5), pages 666-677, May.
    • Handle: RePEc:wly:hlthec:v:28:y:2019:i:5:p:666-677
    DOI: 10.1002/hec.3872
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.3872
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.3872?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. David Powell & Rosalie Liccardo Pacula & Erin Taylor, 2015. "How Increasing Medical Access to Opioids Contributes to the Opioid Epidemic: Evidence from Medicare Part D," NBER Working Papers 21072, National Bureau of Economic Research, Inc.
    2. Frean, Molly & Gruber, Jonathan & Sommers, Benjamin D., 2017. "Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act," Journal of Health Economics, Elsevier, vol. 53(C), pages 72-86.
    3. Swensen, Isaac D., 2015. "Substance-abuse treatment and mortality," Journal of Public Economics, Elsevier, vol. 122(C), pages 13-30.
    4. Bradley Heim & Ithai Lurie & Kosali Simon, 2018. "The Impact of the Affordable Care Act Young Adult Provision on Childbearing: Evidence From Tax Data," Demography, Springer;Population Association of America (PAA), vol. 55(4), pages 1233-1243, August.
    5. Abby Alpert & David Powell & Rosalie Liccardo Pacula, 2018. "Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids," American Economic Journal: Economic Policy, American Economic Association, vol. 10(4), pages 1-35, November.
    6. Barbaresco, Silvia & Courtemanche, Charles J. & Qi, Yanling, 2015. "Impacts of the Affordable Care Act dependent coverage provision on health-related outcomes of young adults," Journal of Health Economics, Elsevier, vol. 40(C), pages 54-68.
    7. Gal Wettstein, 2018. "The Affordable Care Act's insurance market regulations' effect on coverage," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 454-464, March.
    8. Powell, David & Pacula, Rosalie Liccardo & Taylor, Erin, 2020. "How increasing medical access to opioids contributes to the opioid epidemic: Evidence from Medicare Part D," Journal of Health Economics, Elsevier, vol. 71(C).
    9. Yaa Akosa Antwi & Asako S. Moriya & Kosali Simon, 2013. "Effects of Federal Policy to Insure Young Adults: Evidence from the 2010 Affordable Care Act's Dependent-Coverage Mandate," American Economic Journal: Economic Policy, American Economic Association, vol. 5(4), pages 1-28, November.
    10. Johanna Catherine Maclean & Brendan Saloner, 2018. "Substance Use Treatment Provider Behavior and Healthcare Reform: Evidence from Massachusetts," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 76-101, January.
    11. Doleac, Jennifer & Mukherjee, Anita, 2018. "The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime," IZA Discussion Papers 11489, Institute of Labor Economics (IZA).
    12. Michael L. Anderson & Carlos Dobkin & Tal Gross, 2014. "The Effect of Health Insurance on Emergency Department Visits: Evidence from an Age-Based Eligibility Threshold," The Review of Economics and Statistics, MIT Press, vol. 96(1), pages 189-195, March.
    13. Jungtaek Lee, 2018. "Effects of health insurance coverage on risky behaviors," Health Economics, John Wiley & Sons, Ltd., vol. 27(4), pages 762-777, April.
    14. Akosa Antwi, Yaa & Moriya, Asako S. & Simon, Kosali I., 2015. "Access to health insurance and the use of inpatient medical care: Evidence from the Affordable Care Act young adult mandate," Journal of Health Economics, Elsevier, vol. 39(C), pages 171-187.
    15. Yu-Wei Luke Chu, 2015. "Do Medical Marijuana Laws Increase Hard-Drug Use?," Journal of Law and Economics, University of Chicago Press, vol. 58(2), pages 481-517.
    16. Powell, David & Pacula, Rosalie Liccardo & Jacobson, Mireille, 2018. "Do medical marijuana laws reduce addictions and deaths related to pain killers?," Journal of Health Economics, Elsevier, vol. 58(C), pages 29-42.
    17. Anca M. Grecu & Dhaval M. Dave & Henry Saffer, 2019. "Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(1), pages 181-209, January.
    18. Christopher J. Ruhm, 2018. "Deaths of Despair or Drug Problems?," NBER Working Papers 24188, National Bureau of Economic Research, Inc.
    19. Michael Anderson & Carlos Dobkin & Tal Gross, 2012. "The Effect of Health Insurance Coverage on the Use of Medical Services," American Economic Journal: Economic Policy, American Economic Association, vol. 4(1), pages 1-27, February.
    20. Anne Case & Angua Deaton, 2015. "Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century," Working Papers 15078.full.pdf, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    21. Thomas C. Buchmueller & Colleen Carey, 2018. "The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 77-112, February.
    22. Jill Horwitz & Corey S. Davis & Lynn S. McClelland & Rebecca S. Fordon & Ellen Meara, 2018. "The Problem of Data Quality in Analyses of Opioid Regulation: The Case of Prescription Drug Monitoring Programs," NBER Working Papers 24947, National Bureau of Economic Research, Inc.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Andrei Barbos & Minglu Sun, 2021. "The effect of awarding disability benefits on opioid consumption," Health Economics, John Wiley & Sons, Ltd., vol. 30(11), pages 2794-2807, November.
    2. Jing Xu & Nazik M. A. Zakari & Hanadi Y. Hamadi & Sinyoung Park & Donald Rob Haley & Mei Zhao, 2021. "The Financial Burden of Opioid-Related Abuse among Surgical and Non-Surgical Patients in Florida: A Longitudinal Study," IJERPH, MDPI, vol. 18(17), pages 1-10, August.
    3. Susan L. Averett & Julie K. Smith & Yang Wang, 2019. "Medicaid expansion and opioid deaths," Health Economics, John Wiley & Sons, Ltd., vol. 28(12), pages 1491-1496, December.
    4. Maclean, Johanna Catherine & Tello-Trillo, Sebastian & Webber, Douglas, 2023. "Losing insurance and psychiatric hospitalizations," Journal of Economic Behavior & Organization, Elsevier, vol. 205(C), pages 508-527.
    5. Fone, Zachary S. & Friedson, Andrew I. & Lipton, Brandy & Sabia, Joseph J., 2020. "The Dependent Coverage Mandate Took a Bite Out of Crime," IZA Discussion Papers 12968, Institute of Labor Economics (IZA).
    6. Johanna Catherine Maclean & Justine Mallatt & Christopher J. Ruhm & Kosali Simon, 2022. "The Opioid Crisis, Health, Healthcare, and Crime: A Review of Quasi-Experimental Economic Studies," The ANNALS of the American Academy of Political and Social Science, , vol. 703(1), pages 15-49, September.
    7. DiNardi, Michael, 2019. "Uninsurance and Purchases of Prescription Drugs with High Rates of Misuse: Evidence from the Federal Dependent Coverage Mandate," MPRA Paper 97769, University Library of Munich, Germany.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Deiana Claudio & Giua Ludovica, 2021. "The Intended and Unintended Effects of Opioid Policies on Prescription Opioids and Crime," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 21(2), pages 751-792, April.
    2. David Beheshti, 2019. "Adverse health effects of abuse‐deterrent opioids: Evidence from the reformulation of OxyContin," Health Economics, John Wiley & Sons, Ltd., vol. 28(12), pages 1449-1461, December.
    3. Christopher J. Ruhm, 2018. "Deaths of Despair or Drug Problems?," NBER Working Papers 24188, National Bureau of Economic Research, Inc.
    4. Ruhm, Christopher J., 2019. "Drivers of the fatal drug epidemic," Journal of Health Economics, Elsevier, vol. 64(C), pages 25-42.
    5. Johanna Catherine Maclean & Justine Mallatt & Christopher J. Ruhm & Kosali Simon, 2022. "The Opioid Crisis, Health, Healthcare, and Crime: A Review of Quasi-Experimental Economic Studies," The ANNALS of the American Academy of Political and Social Science, , vol. 703(1), pages 15-49, September.
    6. Johanna Catherine Maclean & Brendan Saloner, 2019. "The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(2), pages 366-393, March.
    7. Pohl, R. Vincent, 2018. "Time Trends Matter: The Case of Medical Cannabis Laws and Opioid Overdose Mortality," MPRA Paper 88219, University Library of Munich, Germany.
    8. Gihleb, Rania & Giuntella, Osea & Zhang, Ning, 2020. "Prescription drug monitoring programs and neonatal outcomes," Regional Science and Urban Economics, Elsevier, vol. 81(C).
    9. Aliprantis, Dionissi & Fee, Kyle & Schweitzer, Mark E., 2023. "Opioids and the labor market," Labour Economics, Elsevier, vol. 85(C).
    10. Garin, Julio & Pohl, R. Vincent & Smith, Rhet A., 2018. "The Effect of Medical Cannabis Dispensaries on Opioid and Heroin Overdose Mortality," MPRA Paper 89613, University Library of Munich, Germany.
    11. Powell, David & Pacula, Rosalie Liccardo & Taylor, Erin, 2020. "How increasing medical access to opioids contributes to the opioid epidemic: Evidence from Medicare Part D," Journal of Health Economics, Elsevier, vol. 71(C).
    12. Lucy Xiaolu Wang, 2021. "The complementarity of drug monitoring programs and health IT for reducing opioid‐related mortality and morbidity," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2026-2046, September.
    13. Christopher J. Ruhm, 2019. "Shackling the Identification Police?," Southern Economic Journal, John Wiley & Sons, vol. 85(4), pages 1016-1026, April.
    14. Amy Finkelstein & Matthew Gentzkow & Dean Li & Heidi L. Williams, 2022. "What Drives Risky Prescription Opioid Use? Evidence from Migration," NBER Working Papers 30471, National Bureau of Economic Research, Inc.
    15. Simone Balestra & Helge Liebert & Nicole Maestas & Tisamarie B. Sherry, 2021. "Behavioral Responses to Supply-Side Drug Policy During the Opioid Epidemic," NBER Working Papers 29596, National Bureau of Economic Research, Inc.
    16. Alice M. Ellyson & Jevay Grooms & Alberto Ortega, 2022. "Flipping the script: The effects of opioid prescription monitoring on specialty‐specific provider behavior," Health Economics, John Wiley & Sons, Ltd., vol. 31(2), pages 297-341, February.
    17. Gihleb, Rania & Giuntella, Osea & Zhang, Ning, 2018. "The Effects of Mandatory Prescription Drug Monitoring Programs on Foster Care Admissions," IZA Discussion Papers 11470, Institute of Labor Economics (IZA).
    18. Cotti, Chad D. & Gordanier, John M. & Ozturk, Orgul D., 2020. "The relationship of opioid prescriptions and the educational performance of children," Social Science & Medicine, Elsevier, vol. 265(C).
    19. Shishir Shakya & Collin Hodges, 2023. "Must‐access prescription drug monitoring programs and retail opioid sales," Contemporary Economic Policy, Western Economic Association International, vol. 41(1), pages 146-165, January.
    20. Yörük Barış K., 2018. "Health insurance coverage and health care utilization: Evidence from the Affordable Care Act’s dependent coverage mandate," Forum for Health Economics & Policy, De Gruyter, vol. 21(2), pages 1-24, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:28:y:2019:i:5:p:666-677. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.