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The Affordable Care Act's insurance market regulations' effect on coverage

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  • Gal Wettstein

Abstract

Much of the debate surrounding reform of the Patient Protection and Affordable Care Act (ACA) revolves around its insurance market regulation. This paper studies the impact on health insurance coverage of those provisions. Using data from the American Community Survey, years 2008–2015, I focus on individuals, ages 26 to 64, who are ineligible for the subsidies or Medicaid expansions included in the ACA to isolate the effect of its market regulation. To account for time trends, I utilize a differences‐in‐differences approach with a control group of residents of Massachusetts who were already subject to a similarly regulated health insurance market. I find that the ACA's regulations caused an increase of 0.95 percentage points in health insurance coverage for my sample in 2014. This increase was concentrated among younger individuals, suggesting that the law's regulations ameliorated adverse selection in the individual health insurance market.

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  • 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.
    • Handle: RePEc:wly:hlthec:v:27:y:2018:i:3:p:454-464
    DOI: 10.1002/hec.3585
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    References listed on IDEAS

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    1. Martin B. Hackmann & Jonathan T. Kolstad & Amanda E. Kowalski, 2015. "Adverse Selection and an Individual Mandate: When Theory Meets Practice," American Economic Review, American Economic Association, vol. 105(3), pages 1030-1066, March.
    2. Raj Chetty & Adam Looney & Kory Kroft, 2009. "Salience and Taxation: Theory and Evidence," American Economic Review, American Economic Association, vol. 99(4), pages 1145-1177, September.
    3. 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.
    4. Kolstad, Jonathan T. & Kowalski, Amanda E., 2016. "Mandate-based health reform and the labor market: Evidence from the Massachusetts reform," Journal of Health Economics, Elsevier, vol. 47(C), pages 81-106.
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    Cited by:

    1. Shelley I. White-Means & Ahmad Reshad Osmani, 2018. "Affordable Care Act and Disparities in Health Services Utilization among Ethnic Minority Breast Cancer Survivors: Evidence from Longitudinal Medical Expenditure Panel Surveys 2008–2015," IJERPH, MDPI, vol. 15(9), pages 1-26, August.
    2. Reagan A. Baughman, 2022. "The Affordable Care Act and regulation: Coverage effects of guaranteed issue and ratings reform," Health Economics, John Wiley & Sons, Ltd., vol. 31(12), pages 2575-2592, December.
    3. 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.

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