IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v30y2021i5p1200-1221.html
   My bibliography  Save this article

Private coverage mandates, business cycles, and provider treatment intensity

Author

Listed:
  • Michael R. Richards
  • Sebastian Tello‐Trillo

Abstract

The Affordable Care Act (ACA) is the source of multiple large‐scale health insurance expansions affecting various segments of the US population. Although much has been done to quantify the first‐order effects of these policies, less empirical investigation has been devoted to the effects on the supply‐side of health care. We focus on a well‐known ACA initiative (the young adult dependent coverage mandate) to offer novel evidence on two fronts: the policy's heterogeneous effect across different labor markets and the potential for the policy‐induced shift in payer mix to influence provider treatment decisions. First, we show that the federal mandate's direct effect on young adult private insurance take‐up is strongly mitigated by the Great Recession. Second, we demonstrate that providers do not treat young adults more aggressively when more of them hold private coverage. Policymakers should keep these broader considerations and more diffuse risk protection implications in mind when contemplating changes to the law.

Suggested Citation

  • Michael R. Richards & Sebastian Tello‐Trillo, 2021. "Private coverage mandates, business cycles, and provider treatment intensity," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1200-1221, May.
  • Handle: RePEc:wly:hlthec:v:30:y:2021:i:5:p:1200-1221
    DOI: 10.1002/hec.4250
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.4250
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.4250?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. Gregory Colman & Dhaval Dave, 2018. "It'S About Time: Effects Of The Affordable Care Act Dependent Coverage Mandate On Time Use," Contemporary Economic Policy, Western Economic Association International, vol. 36(1), pages 44-58, January.
    2. 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.
    3. Bhashkar Mazumder & Sarah Miller, 2016. "The Effects of the Massachusetts Health Reform on Household Financial Distress," American Economic Journal: Economic Policy, American Economic Association, vol. 8(3), pages 284-313, August.
    4. 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.
    5. Youjin Hahn & Hee-Seung Yang, 2016. "Do Work Decisions among Young Adults Respond to Extended Dependent Coverage?," ILR Review, Cornell University, ILR School, vol. 69(3), pages 737-771, May.
    6. Schaller, Jessamyn & Stevens, Ann Huff, 2015. "Short-run effects of job loss on health conditions, health insurance, and health care utilization," Journal of Health Economics, Elsevier, vol. 43(C), pages 190-203.
    7. Dan M. Shane & David M. Zimmer, 2017. "Is the ACA bringing the family back together (for tax purposes)? Investigating the dependent coverage mandate effect on dependent tax exemptions," Review of Economics of the Household, Springer, vol. 15(4), pages 1159-1176, December.
    8. Cardella, Eric & Depew, Briggs, 2014. "The effect of health insurance coverage on the reported health of young adults," Economics Letters, Elsevier, vol. 124(3), pages 406-410.
    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. Brigitte C. Madrian, 1994. "Employment-Based Health Insurance and Job Mobility: Is there Evidence of Job-Lock?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 109(1), pages 27-54.
    11. Hu, Luojia & Kaestner, Robert & Mazumder, Bhashkar & Miller, Sarah & Wong, Ashley, 2018. "The effect of the affordable care act Medicaid expansions on financial wellbeing," Journal of Public Economics, Elsevier, vol. 163(C), pages 99-112.
    12. Sarah Miller & Luojia Hu & Robert Kaestner & Bhashkar Mazumder & Ashley Wong, 2021. "The ACA Medicaid Expansion in Michigan and Financial Health," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(2), pages 348-375, March.
    13. Craig Garthwaite & Tal Gross & Matthew J. Notowidigdo, 2018. "Hospitals as Insurers of Last Resort," American Economic Journal: Applied Economics, American Economic Association, vol. 10(1), pages 1-39, January.
    14. Depew, Briggs, 2015. "The effect of state dependent mandate laws on the labor supply decisions of young adults," Journal of Health Economics, Elsevier, vol. 39(C), pages 123-134.
    15. 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.
    16. Kenneth Brevoort & Daniel Grodzicki & Martin B. Hackmann, 2017. "Medicaid and Financial Health," NBER Working Papers 24002, National Bureau of Economic Research, Inc.
    17. Lee, Daeyong, 2016. "Effects of dependent coverage mandate on household precautionary savings: Evidence from the 2010 Affordable Care Act," Economics Letters, Elsevier, vol. 147(C), pages 32-37.
    18. Gopi Shah Goda & Monica Farid & Jay Bhattacharya, 2016. "The Incidence of Mandated Health Insurance: Evidence from the Affordable Care Act Dependent Care Mandate," NBER Working Papers 21846, National Bureau of Economic Research, Inc.
    19. Johar, Meliyanni, 2012. "Do doctors charge high income patients more?," Economics Letters, Elsevier, vol. 117(3), pages 596-599.
    20. Depew, Briggs & Bailey, James, 2015. "Did the Affordable Care Act's dependent coverage mandate increase premiums?," Journal of Health Economics, Elsevier, vol. 41(C), pages 1-14.
    21. Bradley Heim & Ithai Lurie & Kosali I. Simon, 2017. "The Impact of the Affordable Care Act Young Adult Provision on Childbearing, Marriage, and Tax Filing Behavior: Evidence from Tax Data," NBER Working Papers 23092, National Bureau of Economic Research, Inc.
    22. Argys, Laura M. & Friedson, Andrew I. & Pitts, M. Melinda & Tello-Trillo, D. Sebastian, 2020. "Losing public health insurance: TennCare reform and personal financial distress," Journal of Public Economics, Elsevier, vol. 187(C).
    23. Bradley Heim & Ithai Lurie & Kosali Simon, 2015. "The Impact of the Affordable Care Act Young Adult Provision on Labor Market Outcomes: Evidence from Tax Data," Tax Policy and the Economy, University of Chicago Press, vol. 29(1), pages 133-157.
    24. David J G Slusky, 2017. "Significant Placebo Results in Difference-in-Differences Analysis: The Case of the ACA’s Parental Mandate," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 43(4), pages 580-603, September.
    Full references (including those not matched with items on IDEAS)

    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. Nathan Blascak & Vyacheslav Mikhed, 2023. "Health Insurance and Young Adult Financial Distress," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(2), pages 393-423, March.
    2. Joelle Abramowitz, 2018. "Planning parenthood: the Affordable Care Act young adult provision and pathways to fertility," Journal of Population Economics, Springer;European Society for Population Economics, vol. 31(4), pages 1097-1123, October.
    3. 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).
    4. Juergen Jung & Vinish Shrestha, 2018. "The Affordable Care Act And College Enrollment Decisions," Economic Inquiry, Western Economic Association International, vol. 56(4), pages 1980-2009, October.
    5. Jie Ma & Kosali I. Simon, 2020. "Heterogeneous Effects Of Health Insurance On Birth Related Outcomes: Unpacking Compositional Vs. Direct Changes," NBER Working Papers 27728, National Bureau of Economic Research, Inc.
    6. David J. G. Slusky & Donna K. Ginther, 2021. "Did Medicaid expansion reduce medical divorce?," Review of Economics of the Household, Springer, vol. 19(4), pages 1139-1174, December.
    7. Gopi Shah Goda & Monica Farid & Jay Bhattacharya, 2016. "The Incidence of Mandated Health Insurance: Evidence from the Affordable Care Act Dependent Care Mandate," NBER Working Papers 21846, National Bureau of Economic Research, Inc.
    8. Bradley Heim & Ithai Lurie & Kosali Simon, 2018. "Did the Affordable Care Act Young Adult Provision Affect Labor Market Outcomes? Analysis Using Tax Data," ILR Review, Cornell University, ILR School, vol. 71(5), pages 1154-1178, October.
    9. Michael S. Kofoed & Wyatt J. Frasier, 2019. "[Job] Locked and [Un]loaded: The Effect of the Affordable Care Act Dependency Mandate on Reenlistment in the U.S. Army," Upjohn Working Papers 19-300, W.E. Upjohn Institute for Employment Research.
    10. Gamino Aaron M., 2021. "The Effect of Health Insurance on Young Adult HIV Testing: Evidence from the Affordable Care Act Dependent Coverage Mandate," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 21(1), pages 147-174, January.
    11. James Bailey, 2017. "Health insurance and the supply of entrepreneurs: new evidence from the affordable care act," Small Business Economics, Springer, vol. 49(3), pages 627-646, October.
    12. Jungtaek Lee, 2018. "Effects of health insurance coverage on risky behaviors," Health Economics, John Wiley & Sons, Ltd., vol. 27(4), pages 762-777, April.
    13. Otto Lenhart & Vinish Shrestha, 2016. "The Effect of the Health Insurance Mandate on Labor Market Activity and Time Allocation: Evidence from the Federal Dependent Coverage Provision," Working Papers 2016-10, Towson University, Department of Economics, revised Apr 2016.
    14. Bradley Heim & Ithai Lurie & Kosali Simon, 2015. "The Impact of the Affordable Care Act Young Adult Provision on Labor Market Outcomes: Evidence from Tax Data," Tax Policy and the Economy, University of Chicago Press, vol. 29(1), pages 133-157.
    15. Scott Barkowski & Joanne Song McLaughlin & Alex Ray, 2020. "A Reevaluation of the Effects of State and ACA Dependent Coverage Mandates on Health Insurance Coverage," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(3), pages 629-663, June.
    16. Lennon, Conor, 2021. "Are the costs of employer-sponsored health insurance passed on to workers at the individual level?," Economics & Human Biology, Elsevier, vol. 41(C).
    17. Gregory Colman & Dhaval Dave, 2018. "It'S About Time: Effects Of The Affordable Care Act Dependent Coverage Mandate On Time Use," Contemporary Economic Policy, Western Economic Association International, vol. 36(1), pages 44-58, January.
    18. David J G Slusky, 2017. "Significant Placebo Results in Difference-in-Differences Analysis: The Case of the ACA’s Parental Mandate," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 43(4), pages 580-603, September.
    19. Pinka Chatterji & Xiangshi Liu & Barış K. Yörük, 2022. "Health insurance and the boomerang generation: Did the 2010 ACA dependent care provision affect geographic mobility and living arrangements among young adults?," Contemporary Economic Policy, Western Economic Association International, vol. 40(2), pages 243-262, April.
    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:30:y:2021:i:5:p:1200-1221. 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.