IDEAS home Printed from https://ideas.repec.org/p/iza/izadps/dp15346.html
   My bibliography  Save this paper

Does Public Policy Affect Attitudes? Evidence from Age-Based Health Insurance Coverage Policies in the United States

Author

Listed:
  • Yörük, Baris

    (University at Albany, SUNY)

Abstract

The existing literature provides evidence that public opinion and attitudes often affect public policy. However, little is known on how public policy might affect public attitudes and norms. I present new evidence on this topic by using age-based health insurance policies in the United States as natural experiments. I first exploit the discrete change in insurance coverage rates at age 26 due to the Affordable Care Act's dependent coverage mandate and show that this policy is associated with statistically significant deterioration in attitudes towards the necessity of health insurance among young adults who are affected by this policy the most. Next, I show that gaining health insurance at 65 due to the onset of Medicare does not have a significant impact on attitudes towards health insurance among the elderly. These findings are widespread across different demographic groups, robust under alternative model specifications, observed only after the policies are adopted, and highlight the importance of age in attitude formation.

Suggested Citation

  • Yörük, Baris, 2022. "Does Public Policy Affect Attitudes? Evidence from Age-Based Health Insurance Coverage Policies in the United States," IZA Discussion Papers 15346, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp15346
    as

    Download full text from publisher

    File URL: https://docs.iza.org/dp15346.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Silvia Helena Barcellos & Mireille Jacobson, 2015. "The Effects of Medicare on Medical Expenditure Risk and Financial Strain," American Economic Journal: Economic Policy, American Economic Association, vol. 7(4), pages 41-70, November.
    2. Aksoy, Cevat G. & Carpenter, Christopher S. & De Haas, Ralph & Tran, Kevin D., 2020. "Do laws shape attitudes? Evidence from same-sex relationship recognition policies in Europe," European Economic Review, Elsevier, vol. 124(C).
    3. Dillender, Marcus, 2015. "The effect of health insurance on workers’ compensation filing: Evidence from the affordable care act's age-based threshold for dependent coverage," Journal of Health Economics, Elsevier, vol. 43(C), pages 204-228.
    4. Alison L. Booth & Patrick Nolen, 2012. "Gender differences in risk behaviour: does nurture matter?," Economic Journal, Royal Economic Society, vol. 122(558), pages 56-78, February.
    5. Cooter, Robert, 1998. "Expressive Law and Economics," Berkeley Olin Program in Law & Economics, Working Paper Series qt3w34j60j, Berkeley Olin Program in Law & Economics.
    6. Soss, Joe & Schram, Sanford F., 2007. "A Public Transformed? Welfare Reform as Policy Feedback," American Political Science Review, Cambridge University Press, vol. 101(1), pages 111-127, February.
    7. Imbens, Guido W. & Lemieux, Thomas, 2008. "Regression discontinuity designs: A guide to practice," Journal of Econometrics, Elsevier, vol. 142(2), pages 615-635, February.
    8. Pinka Chatterji & Xiangshi Liu & Barış K. Yörük, 2022. "Health insurance and the boomerang generation: Did the 2010 ACA dependent care provision affect geographic mobility and living arrangements among young adults?," Contemporary Economic Policy, Western Economic Association International, vol. 40(2), pages 243-262, April.
    9. Powell, Melanie & Ansic, David, 1997. "Gender differences in risk behaviour in financial decision-making: An experimental analysis," Journal of Economic Psychology, Elsevier, vol. 18(6), pages 605-628, November.
    10. Yörük Barış K., 2018. "Health insurance coverage and health care utilization: Evidence from the Affordable Care Act’s dependent coverage mandate," Forum for Health Economics & Policy, De Gruyter, vol. 21(2), pages 1-24, December.
    11. Arni, Patrick, 2015. "Opening the Blackbox: How Does Labor Market Policy Affect the Job Seekers' Behavior? A Field Experiment," IZA Discussion Papers 9617, Institute of Labor Economics (IZA).
    12. Buchmueller, T.C. & Levinson, Z.M. & Levy, H.G. & Wolfe, B.L., 2016. "Effect of the affordable care act on racial and ethnic disparities in health insurance coverage," American Journal of Public Health, American Public Health Association, vol. 106(8), pages 1416-1421.
    13. Tu T. Nguyen & Barış K. Yörük, 2020. "Aging out of dependent coverage and the effects on the use of inpatient medical care," International Journal of Health Economics and Management, Springer, vol. 20(4), pages 381-390, December.
    14. Carbonara Emanuela & Parisi Francesco & von Wangenheim Georg, 2008. "Lawmakers as Norm Entrepreneurs," Review of Law & Economics, De Gruyter, vol. 4(3), pages 779-799, December.
    15. Hahn, Jinyong & Todd, Petra & Van der Klaauw, Wilbert, 2001. "Identification and Estimation of Treatment Effects with a Regression-Discontinuity Design," Econometrica, Econometric Society, vol. 69(1), pages 201-209, January.
    16. Kotsadam, Andreas & Jakobsson, Niklas, 2011. "Do laws affect attitudes? An assessment of the Norwegian prostitution law using longitudinal data," International Review of Law and Economics, Elsevier, vol. 31(2), pages 103-115, June.
    17. Dahlen, H.M., 2015. ""Aging out" of dependent coverage and the effects on us labor market and health insurance choices," American Journal of Public Health, American Public Health Association, vol. 105, pages 640-650.
    18. Cooter, Robert, 1998. "Expressive Law and Economics," The Journal of Legal Studies, University of Chicago Press, vol. 27(2), pages 585-608, June.
    19. David S. Lee & Thomas Lemieux, 2010. "Regression Discontinuity Designs in Economics," Journal of Economic Literature, American Economic Association, vol. 48(2), pages 281-355, June.
    20. David Card & Carlos Dobkin & Nicole Maestas, 2009. "Does Medicare Save Lives?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(2), pages 597-636.
    21. Barış K. Yörük & Linna Xu, 2019. "Impact of the ACA’s Dependent Coverage Mandate on Health Insurance and Labor Market Outcomes Among Young Adults: Evidence from Regression Discontinuity Design," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 45(1), pages 58-86, January.
    22. Bhavnani, Rikhil R., 2009. "Do Electoral Quotas Work after They Are Withdrawn? Evidence from a Natural Experiment in India," American Political Science Review, Cambridge University Press, vol. 103(1), pages 23-35, February.
    23. Matias Cattaneo & Rocio Titiunik & Gonzalo Vazquez-Bare, 2019. "Power calculations for regression-discontinuity designs," Stata Journal, StataCorp LP, vol. 19(1), pages 210-245, March.
    24. David Card & Carlos Dobkin & Nicole Maestas, 2008. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization: Evidence from Medicare," American Economic Review, American Economic Association, vol. 98(5), pages 2242-2258, December.
    25. Jungtaek Lee, 2018. "Effects of health insurance coverage on risky behaviors," Health Economics, John Wiley & Sons, Ltd., vol. 27(4), pages 762-777, April.
    26. Sebastian Calonico & Matias D. Cattaneo & Max H. Farrell & Roc ́ıo Titiunik, 2017. "rdrobust: Software for regression-discontinuity designs," Stata Journal, StataCorp LP, vol. 17(2), pages 372-404, June.
    27. Robert Cooter, 1998. "Expressive Law and Economics," CESifo Working Paper Series 161, CESifo.
    28. Pinka Chatterji & Tu Nguyen & Bariş K. Yörük, 2022. "The Effects of Medicare on Health-Care Utilization and Spending Among the Elderly," American Journal of Health Economics, University of Chicago Press, vol. 8(2), pages 151-180.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Ha Trong Nguyen & Le, Huong Thu & Blyth, Christopher & Connelly, Luke & Mitrou, Francis, 2024. "Identifying the effects of health insurance coverage on health care use when coverage is misreported and endogenous," GLO Discussion Paper Series 1432, Global Labor Organization (GLO).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Barış K. Yörük & Yiran Han, 2024. "Age-based health insurance coverage policies and mental health," Journal of Population Economics, Springer;European Society for Population Economics, vol. 37(2), pages 1-26, June.
    2. Yörük Barış K., 2018. "Health insurance coverage and health care utilization: Evidence from the Affordable Care Act’s dependent coverage mandate," Forum for Health Economics & Policy, De Gruyter, vol. 21(2), pages 1-24, December.
    3. Tu T. Nguyen & Barış K. Yörük, 2020. "Aging out of dependent coverage and the effects on the use of inpatient medical care," International Journal of Health Economics and Management, Springer, vol. 20(4), pages 381-390, December.
    4. Christelis, Dimitris & Georgarakos, Dimitris & Sanz-de-Galdeano, Anna, 2020. "The impact of health insurance on stockholding: A regression discontinuity approach," Journal of Health Economics, Elsevier, vol. 69(C).
    5. Rebecca M. Myerson & Reginald D. Tucker‐Seeley & Dana P. Goldman & Darius N. Lakdawalla, 2020. "Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes?," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(3), pages 577-604, June.
    6. Kotsadam, Andreas & Jakobsson, Niklas, 2011. "Do laws affect attitudes? An assessment of the Norwegian prostitution law using longitudinal data," International Review of Law and Economics, Elsevier, vol. 31(2), pages 103-115, June.
    7. Francis, Andrew M. & Mialon, Hugo M. & Peng, Handie, 2012. "In sickness and in health: Same-sex marriage laws and sexually transmitted infections," Social Science & Medicine, Elsevier, vol. 75(8), pages 1329-1341.
    8. Fitzpatrick, Maria D. & Moore, Timothy J., 2018. "The mortality effects of retirement: Evidence from Social Security eligibility at age 62," Journal of Public Economics, Elsevier, vol. 157(C), pages 121-137.
    9. Mauricio Villamizar‐Villegas & Freddy A. Pinzon‐Puerto & Maria Alejandra Ruiz‐Sanchez, 2022. "A comprehensive history of regression discontinuity designs: An empirical survey of the last 60 years," Journal of Economic Surveys, Wiley Blackwell, vol. 36(4), pages 1130-1178, September.
    10. Patrick Hullegie & Tobias J. Klein, 2010. "The effect of private health insurance on medical care utilization and self‐assessed health in Germany," Health Economics, John Wiley & Sons, Ltd., vol. 19(9), pages 1048-1062, September.
    11. Hullegie, P.G.J., 2012. "Essays on health and labor economics," Other publications TiSEM dcc68fc9-7af1-4ba9-8f90-6, Tilburg University, School of Economics and Management.
    12. Oh, Byeung-Kuk, 2024. "Retirement and healthcare utilization: Evidence from pension eligibility ages in South Korea," The Journal of the Economics of Ageing, Elsevier, vol. 27(C).
    13. Myerson, Rebecca & Lu, Tianyi & Yuan, Yong & Liu, Gordon, 2020. "The impact of government income transfers on tobacco and alcohol use: Evidence from China," Economics Letters, Elsevier, vol. 186(C).
    14. repec:dau:papers:123456789/9533 is not listed on IDEAS
    15. Sophie Guthmuller & Jérôme Wittwer, 2017. "The Impact of the Eligibility Threshold of a French Means‐Tested Health Insurance Programme on Doctor Visits: A Regression Discontinuity Analysis," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 17-34, December.
    16. Ivan A Canay & Vishal Kamat, 2018. "Approximate Permutation Tests and Induced Order Statistics in the Regression Discontinuity Design," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 85(3), pages 1577-1608.
    17. Sebastian Calonico & Matias D. Cattaneo & Max H. Farrell & Rocío Titiunik, 2019. "Regression Discontinuity Designs Using Covariates," The Review of Economics and Statistics, MIT Press, vol. 101(3), pages 442-451, July.
    18. Xi Chen, 2017. "Old age pension and intergenerational living arrangements: a regression discontinuity design," Review of Economics of the Household, Springer, vol. 15(2), pages 455-476, June.
    19. Gurgand, Marc & Lorenceau, Adrien & Mélonio, Thomas, 2023. "Student loans: Credit constraints and higher education in South Africa," Journal of Development Economics, Elsevier, vol. 161(C).
    20. David Wilkinson & Rebecca Riley, 2011. "The UK Minimum Wage at Age 22: A Regression Discontinuity Approach," National Institute of Economic and Social Research (NIESR) Discussion Papers 378, National Institute of Economic and Social Research.
    21. Dolores De la Mata & Carlos Felipe Gaviria, 2015. "Losing Health Insurance When Young: Impacts on Usage of Medical Services and Health," CINCH Working Paper Series 1508, Universitaet Duisburg-Essen, Competent in Competition and Health, revised Aug 2015.

    More about this item

    Keywords

    attitudes; beliefs; health insurance coverage; public policy;
    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

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:iza:izadps:dp15346. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Holger Hinte (email available below). General contact details of provider: https://edirc.repec.org/data/izaaade.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.