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The Affordable Care Act'S Effects On Patients, Providers, And The Economy: What We'Ve Learned So Far

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  • Jonathan Gruber
  • Benjamin D. Sommers

Abstract

As we approach the tenth anniversary of the passage of the Affordable Care Act, it is important to reflect on what has been learned about the impacts of this major reform. In this paper, we review the literature on the impacts of the ACA on patients, providers, and the economy. We find strong evidence that the ACA's provisions have increased insurance coverage. There is also a clearly positive effect on access to and consumption of health care, with suggestive but more limited evidence on improved health outcomes. There is no evidence of significant reductions in provider access, changes in labor supply, or increased budgetary pressures on state governments, and the law's total federal cost through 2018 has been less than predicted. We conclude by describing key policy implications and future areas for research.

Suggested Citation

  • Jonathan Gruber & Benjamin D. Sommers, 2019. "The Affordable Care Act'S Effects On Patients, Providers, And The Economy: What We'Ve Learned So Far," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(4), pages 1028-1052, September.
    • Handle: RePEc:wly:jpamgt:v:38:y:2019:i:4:p:1028-1052
    DOI: 10.1002/pam.22158
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    Cited by:

    1. 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.
    2. Jun Yeong Lee & John V. Winters, 2022. "State Medicaid Expansion and the Self-Employed," Small Business Economics, Springer, vol. 59(3), pages 925-954, October.
    3. Friederike Seifert, 2022. "The Affordable Care Act Medicaid expansion and interstate migration in border regions of US States [Die Ausweitung von Medicaid durch den Affordable Care Act und zwischenstaatliche Migration in den," Review of Regional Research: Jahrbuch für Regionalwissenschaft, Springer;Gesellschaft für Regionalforschung (GfR), vol. 42(1), pages 49-74, April.
    4. Kim, Seonghoon & Koh, Kanghyock, 2019. "The Effects of the Affordable Care Act Medicaid Expansion on Subjective Well-being," IZA Discussion Papers 12636, Institute of Labor Economics (IZA).
    5. Frederick, Joshua D. & Fung, Derrick W.H. & Yang, Charles C. & Yeh, Jason J.H., 2022. "Individual health insurance reforms in the U.S.: Expanding interstate markets, Medicare for all, or Medicaid for all?," European Journal of Operational Research, Elsevier, vol. 297(2), pages 753-765.
    6. Sarah Miller & Norman Johnson & Laura R Wherry, 2021. "Medicaid and Mortality: New Evidence From Linked Survey and Administrative Data," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 136(3), pages 1783-1829.
    7. 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.
    8. Jonathan Gruber & Benjamin D. Sommers, 2020. "Fiscal Federalism and the Budget Impacts of the Affordable Care Act's Medicaid Expansion," NBER Working Papers 26862, National Bureau of Economic Research, Inc.
    9. Panjwani, Aniket & Xiong, Heyu, 2023. "The causes and consequences of medical crowdfunding," Journal of Economic Behavior & Organization, Elsevier, vol. 205(C), pages 648-667.
    10. Ma, Yuanyuan & Nolan, Anne & Smith, James P., 2020. "Free GP care and psychological health: Quasi-experimental evidence from Ireland," Journal of Health Economics, Elsevier, vol. 72(C).
    11. Dillender, Marcus & Friedson, Andrew & Gian, Cong & Simon, Kosali, 2019. "Does the healthcare educational market respond to short-run local demand?," Economics of Education Review, Elsevier, vol. 73(C).
    12. Luke Petach & David K. Wyant, 2023. "The union advantage: union membership, access to care, and the Affordable Care Act," International Journal of Health Economics and Management, Springer, vol. 23(1), pages 1-26, March.
    13. Lu Wei & Na Liu & Junhua Chen & Jihong Sun, 2022. "Topic Evolution of Chinese COVID-19 Policies Based on Co-Occurrence Clustering Network Analysis," Sustainability, MDPI, vol. 14(4), pages 1-21, February.

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