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Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health

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  • Courtemanche, Charles

    (University of Kentucky)

  • Marton, James

    (Georgia State University)

  • Ukert, Benjamin

    (University of Pennsylvania)

  • Yelowitz, Aaron

    (University of Kentucky)

  • Zapata, Daniela

    (American Institutes for Research)

Abstract

The goal of the Affordable Care Act (ACA) was to achieve nearly universal health insurance coverage through a combination of mandates, subsidies, marketplaces, and Medicaid expansions, most of which took effect in 2014. We use data from the Behavioral Risk Factor Surveillance System to examine the impacts of the ACA on health care access, risky health behaviors, and self-assessed health after two years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from state participation in the Medicaid expansion and pre-ACA uninsured rates. Results suggest that the ACA led to sizeable improvements in access to health care in both Medicaid expansion and non-expansion states, with the gains being larger in expansion states along some dimensions. No statistically significant effects on risky behaviors or self-assessed health emerge for the full sample. However, we find some evidence that the ACA improved self-assessed health among older non-elderly adults, particularly in expansion states.

Suggested Citation

  • Courtemanche, Charles & Marton, James & Ukert, Benjamin & Yelowitz, Aaron & Zapata, Daniela, 2017. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health," IZA Discussion Papers 10649, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp10649
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    More about this item

    Keywords

    obesity; health; Medicaid; health insurance; Affordable Care Act; smoking; drinking;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • 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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