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

Author

Listed:
  • Charles Courtemanche
  • James Marton
  • Benjamin Ukert
  • Aaron Yelowitz
  • Daniela Zapata

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

  • Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2017. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health," NBER Working Papers 23269, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:23269
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    References listed on IDEAS

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    Cited by:

    1. Courtemanche, Charles & Friedson, Andrew I. & Koller, Andrew P. & Rees, Daniel I., 2017. "The Affordable Care Act and Ambulance Response Times," IZA Discussion Papers 10951, Institute for the Study of Labor (IZA).
    2. Jacqueline Fiore, 2017. "The Impact of the Affordable Care Act's Medicaid Expansion on Medicaid Spending by Health Care Service Category," Working Papers 1706, Tulane University, Department of Economics, revised Mar 2018.
    3. Ziebarth, Nicolas R., 2017. "Social Insurance and Health," IZA Discussion Papers 10918, Institute for the Study of Labor (IZA).
    4. Maclean, J. Catherine & Saloner, Brendan, 2017. "The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act," IZA Discussion Papers 10745, Institute for the Study of Labor (IZA).
    5. Itzik Fadlon & Torben Heien Nielsen, 2017. "Family Health Behaviors," NBER Working Papers 24042, National Bureau of Economic Research, Inc.
    6. Johanna Catherine Maclean & Michael F. Pesko & Steven C. Hill, 2017. "The Effect of Insurance Expansions on Smoking Cessation Medication Prescriptions: Evidence from ACA Medicaid Expansions," NBER Working Papers 23450, National Bureau of Economic Research, Inc.
    7. repec:kap:ijhcfe:v:17:y:2017:i:4:d:10.1007_s10754-017-9220-1 is not listed on IDEAS
    8. Johanna Catherine Maclean & Benjamin L. Cook & Nicholas Carson & Michael F. Pesko, 2017. "Public Insurance and Psychotropic Prescription Medications for Mental Illness," NBER Working Papers 23760, National Bureau of Economic Research, Inc.
    9. Argys, Laura & Friedson, Andrew & Pitts, M. Melinda & Tello-Trillo, D. Sebastian, 2017. "Losing Public Health Insurance: TennCare Disenrollment and Personal Financial Distress," FRB Atlanta Working Paper 2017-6, Federal Reserve Bank of Atlanta, revised 01 Sep 2017.

    More about this item

    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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