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The Effects of the Massachusetts Health Reform on Financial Distress

Author

Listed:
  • Mazumder, Bhashkar

    (Federal Reserve Bank of Chicago)

  • Miller, Sarah

    () (University of Notre Dame)

Abstract

A major benefit of health insurance coverage is that it protects the insured from unexpected medical costs that may devastate their personal finances. In this paper, we use detailed credit report information on a large panel of individuals to examine the effect of a major health care reform in Massachusetts in 2006 on a broad set of financial outcomes. The Massachusetts model served as the basis for the Affordable Care Act and allows us to examine the effect of coverage on financial outcomes for the entire population of the uninsured, not just those with very low incomes. We exploit plausibly exogenous variation in the impact of the reform across counties and age groups using levels of pre-reform insurance coverage as a measure of the potential effect of the reform. We find that the reform reduced the total amount of debt that was past due, the fraction of all debt that was past due, improved credit scores and reduced personal bankruptcies. We also find suggestive evidence that the reform lowered the total amount of debt and decreased third party collections. The effects are most pronounced for individuals who had limited access to credit markets before the reform. These results show that health care reform has implications that extend well beyond the health and health care utilization of those who gain insurance coverage.

Suggested Citation

  • Mazumder, Bhashkar & Miller, Sarah, 2014. "The Effects of the Massachusetts Health Reform on Financial Distress," Working Paper Series WP-2014-1, Federal Reserve Bank of Chicago.
  • Handle: RePEc:fip:fedhwp:wp-2014-01
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    References listed on IDEAS

    as
    1. 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.
    2. David B. Gross, 2002. "An Empirical Analysis of Personal Bankruptcy and Delinquency," Review of Financial Studies, Society for Financial Studies, vol. 15(1), pages 319-347, March.
    3. Sarah Miller, 2012. "The Impact of the Massachusetts Health Care Reform on Health Care Use among Children," American Economic Review, American Economic Association, vol. 102(3), pages 502-507, May.
    4. Pashchenko, Svetlana & Porapakkarm, Ponpoje, 2013. "Work Incentives of Medicaid Beneficiaries and The Role of Asset Testing," MPRA Paper 49730, University Library of Munich, Germany.
    5. Miller, Sarah, 2012. "The effect of insurance on emergency room visits: An analysis of the 2006 Massachusetts health reform," Journal of Public Economics, Elsevier, vol. 96(11), pages 893-908.
    6. Kowalski, A. & Kolstad, J., 2010. "The Impact of an Individual Health Insurance Mandate on Hospital and Preventive Care: Evidence from Massachusetts," Health, Econometrics and Data Group (HEDG) Working Papers 10/18, HEDG, c/o Department of Economics, University of York.
    7. Gross, Tal & Notowidigdo, Matthew J., 2011. "Health insurance and the consumer bankruptcy decision: Evidence from expansions of Medicaid," Journal of Public Economics, Elsevier, vol. 95(7-8), pages 767-778, August.
    8. Jonathan Gruber, 2008. "Massachusetts Health Care Reform: The View From One Year Out," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 11(1), pages 51-63, March.
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    Cited by:

    1. Patrick Richard, 2016. "The Burden of Medical Debt Faced by Households with Dependent Children in the United States: Implications for the Affordable Care Act of 2010," Journal of Family and Economic Issues, Springer, vol. 37(2), pages 212-225, June.
    2. Gilad Sorek & David Benjamin, 2016. "Health insurance mandates in a model with consumer bankruptcy," Journal of Regulatory Economics, Springer, vol. 50(2), pages 233-250, October.
    3. Carlos Dobkin & Amy Finkelstein & Raymond Kluender & Matthew J. Notowidigdo, 2018. "The Economic Consequences of Hospital Admissions," American Economic Review, American Economic Association, vol. 108(2), pages 308-352, February.
    4. Argys, Laura & Friedson, Andrew & Pitts, M. Melinda, 2016. "Killer Debt: The Impact of Debt on Mortality," FRB Atlanta Working Paper 2016-14, Federal Reserve Bank of Atlanta.
    5. Kenneth Brevoort & Daniel Grodzicki & Martin B. Hackmann, 2017. "Medicaid and Financial Health," NBER Working Papers 24002, National Bureau of Economic Research, Inc.
    6. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters,in: Economics of Means-Tested Transfer Programs in the United States, Volume 1, pages 21-136 National Bureau of Economic Research, Inc.
    7. Youngsoo Jang, 2016. "Income Inequality, Medical Conditions, and Household Bankruptcy," Proceedings of Economics and Finance Conferences 4206835, International Institute of Social and Economic Sciences.

    More about this item

    Keywords

    Health care reform; health insurance; financial distress;

    JEL classification:

    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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