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The Affordable Care Act and the COVID-19 Pandemic: A Regression Discontinuity Analysis

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Abstract

Did Medicaid expansion under the Affordable Care Act affect the course of the COVID-19 pandemic? We answer this question using a regression discontinuity design for counties near the borders of states that expanded Medicaid with states that did not. Relevant covariates change continuously across the Medicaid expansion frontier. We find that (1) health insurance changes discontinuously at the frontier, (2) COVID-19 testing is discontinuously larger in Medicaid-expanding states, and (3) the fraction of beds occupied in ICUs is discontinuously smaller in Medicaid-expanding states. We also find that (4) COVID- 19 cases and deaths do not change discontinuously at the frontier, with the precision of these estimates being low, but the null result on deaths being general across demographic groups. Finally, we find that (5) smart thermometer readings of fever rates from Kinsa, Inc. do not change discontinuously at the Medicaid expansion frontier.

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  • Ruchi Avtar & Rajashri Chakrabarti & Lindsay Meyerson & William Nober & Maxim L. Pinkovskiy, 2020. "The Affordable Care Act and the COVID-19 Pandemic: A Regression Discontinuity Analysis," Staff Reports 948, Federal Reserve Bank of New York.
    • Handle: RePEc:fip:fednsr:89061
    Note: Revised December 2022.
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    1. repec:thr:techub:10033:y:2022:i:1:p:638-647 is not listed on IDEAS
    2. Boutheina Amri & Nadia Menazla, 2022. "Obamacare During the Pandemic: A Historical, Economic and Sociopolitical Evaluation of the Initial Response of the US Government," Technium Social Sciences Journal, Technium Science, vol. 33(1), pages 638-647, July.

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    More about this item

    Keywords

    Affordable Care Act; COVID-19; Medicaid; regression discontinuity;
    All these keywords.

    JEL classification:

    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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